Membership Application - Barnawa Rahma Cooperative

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Become a member of Rahma Multipurpose Cooperative Society

Personal Info

Salary Details

Complete

MEMBERSHIP APPLICATION FORM - STAFF FORM

Section A - Personal Information

ID No.

Membership No.

Registration Date

Surname *

Other Names *

Home Address *

Office Address

Phone Number *

Email Address *

Date of Birth *

Gender *

State of Origin *

Local Government Area *

Marital Status *

Next of Kin Name *

Relationship to Next of Kin *

Next of Kin Phone *

Next of Kin Address *

Referee Name

Referee ID No

Referee Membership No

Password *

Confirm Password *

Authority to Deduct from Salary

Section B - Salary Deduction Details

Please deduct from my salary the sum of ₦ for the credit of account with Barnawa Rahma Multipurpose Cooperative Society, Nigerian Geological Survey Agency (National Geosciences Research Laboratories Centre) with effect from and until further notice.

IPPIS NO *

Department *

Monthly Salary *

Date of First Appointment *

Expected Date of Retirement

Application Submitted Successfully!

Thank you for your membership application. We will review your information and contact you soon.

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