Registration Form – KWASANG – Kwara State Association of Nigeria UK

MEMBERSHIP REGISTRATION FORM

Please fill the form below to register to become an Official member of Kwara State Association of Nigeria, UK.
Note: All the fields with asterisks are compulsory and cannot be left blank.

First Name

Middle Name

Surname

Date of Birth

Place of Birth

Home Town

Local Government

Address

Mobile Phone

Profession/Business

Any Additional Info

Registered Office Address: 35, Blackstone Road, London, N4 2JF
Website: www.kwasang.org.uk
E-mail: in**@kw*****.uk
Dr. Omotayo Kash-Oladosu (President - 07846006079)
Dr. Kazeem Salam (General Secretary - Tel: 07588174469)

39511

MEMBERSHIP REGISTRATION FORM

KWASANG

Address:

Contact:

Socials:

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