Agent Application Form
Applicant's Personal Details:
Date of Birth
Alternate Mobile No.
We'll never share your email with anyone else.
County of Residence
Constituency of Voting
Preferred Constituency of Deployment as Agent
Attach Your Cv
Only Word or PDF documents are allowed
Attach Your Copy Of ID
Only JPG,PNG,GIF or PDF documents are allowed
Attach Your Passport Photo
Only JPG,PNG or GIF documents are allowed. Passport size photograph (legible photo taken on a blue background)
Name and Address of Referee:
Mobile Telephone No.
Alternate Mobile Telephone No.
I declare that the information given above are true and correct to the best of my knowledge
Terms and Conditions
Filling this Form does not constitute a Contract but is an expression of intent to contract. A valid agency contract will be signed upon evaluation and satisfactory training.
Due to the fact that the job will entail relaying of election results via a mobile App, applicants need to ensure there is reliable mobile telephony connectivity in their areas, and be conversant to smart telephone use.
After the Application, the agents are expected to be available, for training & deployment instructions, as from
17th July, 2017.
Attach copies of
CV, ID, and Passport size photograph (legible photo taken on a blue background).