Membership Form: Personal Details

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MOTTO: IN TRUTH AND IN TRUST

ADDRESS:

MUNDO LOUNGE, OGUNBIYI STREET, IWAYA, YABA- LAGOS

PHONE NUMBER: 08185533617

EMAIL

ADDRESS: [email protected]/[email protected]

MEMBERSHIP FORM
PERSONAL DETAILS:
SURNAME:.............................................................................................................................................
....................................................................................................................
OTHER
NAME.....................................................................................................................................................
.......................................................................................................
HOME
ADDRESS:..............................................................................................................................................
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OFFICE
ADDRESS:..............................................................................................................................................
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PROPOSED MONTHLY
CONTRIBUTION:.....................................................................................................................................
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MEMBERSHIP
NUMBER:................................................................................................................................................
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PHONE
NUMBER.................................................................................................................................................
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SIGNATURE............................................................................................................................................
...................................................................................................................
NEXT OF
KIN.........................................................................................................................................................
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NEXT OF KIN
ADRESS.................................................................................................................................................
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PHONE
NUMBER.................................................................................................................................................
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SIGNATURE:...........................................................................................................................................
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SECTION B
I.................................................................................................................................................hereby
pledge to abide by the rules governing the cooperative, which I shall remit my monthly dues that
are required by me from time to time. I shall pay a fine of #500 naira if I fail to remit my monthly
dues within at most 2month. I understand that I am entitled to borrow double of the total amount
saved with this cooperative, after 6month membership. I am also aware that I must give a 3month
notice in the event of leaving the cooperative. So help me God.

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MEMBERS SIGNATURE/DATE
BOARD OF DIRECTORS/CHAIRMAN
........................................................................
...........
LAWYER OF THE COOPERATIVE

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