Member Registration

Registration Form

Personal Details
* StaffID: * Gender:
* First Name: * Last Name:
Other Name: * Department:
* Location: * Staff Group:
* SBU:
Year of Birth: * Email:

Contact Details
* Address: * City:
* State: Telephone:

Next of Kin
Full Name: Kin Address:
City: State:
Email: Phone:
Next of Kin's Relationship:

Bank Details
* Bank Name: * Account No:
Bank Branch: Sort Code:

* Savings: Min Savings: 10,000.00



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