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.