Registration

MEMBER REGISTRATION FORM


A. PERSONAL DETAILS

First name:

Last name:

National ID:

Date Of Birth:

Gender:
Male
Female

Marital Status:
Married
Single
Divorced
Widowed


B. CONTACT DETAILS

Physical Address:

Telephone:

E-mail:


C. PARTY GENERAL DETAILS

Joined:

Wing:
Main League
Women’s League
Youth League


C. ELECTORAL INFORMATION

Are you registered to vote?
Yes
No

*On the next page, please upload a passport sized image of yourself, to be used on your membership card.