Membership Registration Form

NOTE: (i). This Form is charged a non-refundable fee of Two Thousand Naira (N2,000.00) as administrative fee. (ii). Your application could be rejected if the Society is not satisfied with your personal data as furnished in Sections A – C. (iii). You can only be granted loan facility after six months of membership.

Step 1 of 8

SECTION A (PERSONAL DATA)

REG. NO.

DATE OF FIRST APPT. *

DATE OF RETIREMENT *

DATE OF APPLICATION *

ORACLE/EMPLOYEE NO

SURNAME *

FIRST NAME *

MIDLE NAME

PERMANENT HOME ADDRESS

Phone *

DATE OF BIRTH *

AGE

SEX

MARITAL STATUS

LOCAL GOVT. AREA OF ORIGIN *

STATE OF ORIGIN

Membership Registration Form

SECTION A (PERSONAL DATA)

SECTION B (NEXT OF KIN)

SECTION C

SECTION D (UNDERTAKEN/AUTHORIZATION)

SECTION E - SALARIED ADDRESS ATTACH A PHOTOCOPY OF THE LAST SALARY PRINTOUT

SECTION F - DEPLOYMENT DETAILS (IF APPLICABLE)

Section G (FOR OFFICE USE ONLY)