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NITA Application - Form 1

This document contains an application form for employers in Kenya to register as a levy contributor with the National Industrial Training Authority. The form requests information such as the name and nature of the employer's business, registration details, location, contact information, total number of employees categorized by role, and a certification by the Chief Executive Officer providing their name and signature. Upon completion, the form should be returned to the Director General of the National Industrial Training Authority in Nairobi.

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Miriam Wanjiru
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2K views1 page

NITA Application - Form 1

This document contains an application form for employers in Kenya to register as a levy contributor with the National Industrial Training Authority. The form requests information such as the name and nature of the employer's business, registration details, location, contact information, total number of employees categorized by role, and a certification by the Chief Executive Officer providing their name and signature. Upon completion, the form should be returned to the Director General of the National Industrial Training Authority in Nairobi.

Uploaded by

Miriam Wanjiru
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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FORM: 1

REPUBLIC OF KENYA

NATIONAL INDUSTRIAL TRAINING AUTHORITY


The Industrial Training Act
(Cap. 237)

APPLICATION FORM FOR REGISTRATION AS A LEVY CONTRIBUTOR

Particulars of the Employer:


1. Name of Employer ………………………………………………………………………………
2. Nature of Business ………………………………………………………………………………..
3. Registered Name of Business ……………………………………………………………………
4. Certificate of Registration No…………………………. (5) Date of Registration …………….
6. Date of Commencement of Business …….……………. (7) Pin …………………….............
8. Location of Registered Office ……………………………………………………………………
Town: …………………………….….. Road/Street ……………………………………………..
Building/Floor ………………………………………………………………………………………
9. P.O. Box ……………………………….……… Code: …………………………………………..
10. Tel. No(s)…………………………………………………………………………………………..
11. Fax No…………………………… (12) E-Mail Address: ……………………………………
13. Website (If Any) ……………………………………………………………………………………
14. Total No. of Employees …………………………………………………………………………...
a) Directors/Managers/Supervisors …………………………………………………...............
b) Non Managerial Staff …………………………………………………………………………
c) Contract Staff ………………………………………………………………………………….
d) Casual/Temporary Staff ……………………………………………………………………...
e) Trainee/Apprentices/Indentured Learners ………………………………………………….
15. a) Name of Contact Officer ……………………………………………………………………….
b) Designation ……………………………………………………………………………………..
I certify that the information given herein is true to the best of my knowledge.

Name: ……………………………………………………………………………………………………
Chief Executive Officer

Signature: …………………………………. Date: ……………………………………….


Seal/Stamp

Note: This return should be forwarded to the Director General, National Industrial
Training Authority, P.O. Box 74494 – 00200, NAIROBI

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