Okerewa Community Development Initiative
Indigene Registeraation Form
FirstName
Surname
Family/Clan Name:
Date of Birth
Gender
Male
Female
Occupation
Farmer
Trader
Doctor
Architect
Technician
Engineer
Carpenter
Nurse
Pharmacist
Teacher
Accountant
Driver
Mobile
profile Photo
Address
Bank Details
Account Name
Account Number
Bank
Means of ID
Means of Identification
--Select Means Of Identification
Permanent Voters Card
Drivers License
NIN Slip
National ID
International Passport
ID Number
Upload Means of ID
Signature
Next Of Kin
FirstName
Last Name
Mobile
Date of Birth
Gender
Male
Female
Relationship
Parent
Brother
Sister
Uncle
Aunty
Daughter
Son
Family Head Details
Title
Mr.
Sir
Chief
HRM
FirstName
Last Name
Mobile
Family Head Signature
User Login Credentials
Email
Password
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