Regformtemp Registration Form IKORODU OGA REGISTRATION FORM New Member Renew Membership First Name: Family Name: * Date of Birth: Contact Address: Post Code *: Telephone One *: Telephone Two: E-mail Address : Gender: Select your sex Male Female Additional Information I understand that some or all the information may be retained for records purposes and hereby give consent to this data being used. I understand that my Membership may be terminated for any Gross misconduct; if I do not attend 40% of the General meeting in any calendar year or keep up with my Membership subscription. I confirmed that the information I have provided is true and correct, I understand that any false and/or misleading statement made by me on this Application form may be sufficient ground for termination of my membership.