New Member Registeration

Fill the form below

Basic Information

Gender

Indicate your gender.

Title

Choose your title.

First Name

Enter your first name.

Last Name

Enter your last name.

Middle Name

Enter your middle name if you have one.

Date of Birth

Choose your date of birth.

Currrent Membership

Enter your current membership number if you have one.

Your media

Profile Photo

PNG or JPG no larger than 2MB

Contact Information

Email Address

Enter your email address if you have one.

Primary Phone Number

Enter your primary phone.

Secondary Phone Number

Enter your secondary phone.

Postal Address

Enter your postal address.

Residential Address

Enter your residential address.

Home Address

Enter your home address.

Home Town Region

Choose your hometwon region.

Family Information

Mother's Name

Enter the name of your mother.

Father's Name

Enter the name of your father.

Next of Kin

Enter next of kin name.

Next of Kin Phone

Enter next of kin phone number.

Marriage Information

Marrital Status

Choose your marrital status.

Marriage Type

Choose your type of marriage.

Date of Marriage

Choose the date of your marriage.

Spouse Name

Enter your spouse name.

Place of Marriage

Enter the name of the place you got married at.

School & Work

Level of Education

Choose your level of education.

Main Occcupation

Choose your main occupation.

Secondary Occcupation

Choose your secondary occupation.

Baptismal Information

Baptised or Not

Indicate wherether or not you have been baptized.

Baptismal Date

Choose your date of baptism.

Place of Baptism

Enter the name of the place you were baptised.

Minister's Name

Enter the name of the minister who baptized you.

Confirmation Information

Confirmed or Not

Indicate wherether or not you have been confirmed.

Confirmation Date

Choose your date of confirmation.

Place of Confirmation

Enter the name of the place you were confirmed at.

Minister's Name

Enter the name of the minister who confirmed you.