Membership-Registration

NIFAAS New Membership Registration & Dues

Full Name *

Email *

Amount (NGN) *

Transaction Charge: , Total:

Please Enter your Title and Names the way it should appear on your membership certificate

Title *

Enter Surname *

Enter Othernames *

Gender

MaleFemale

Enter Phone Number *

Enter Alternate Phone Number

Enter Organization *

Enter Organization/ Postal Address *

Enter Job Title

Job Status

EmployeeSelf-employed

Sector

PublicPrivate

Geographic area of operation

South WestSouth EastSouth SouthNorth CentralNorth WestNorth East

Enter Area of Expertise in Agric Ext. and Advisory Services *

Types of Membership Requested *

IndividualCorporate

Highest Educational Qualification

State *

Country *

* are compulsory
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