Benin National Congress


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Membership form

form

1 Ogbelaka Street Off Sapele Road, Benin City. Nigeria.
Email-beninnationalcongress@yahoo.com


NAME:……………………………………………………………………………………………………………...................................
Surname Other Names

HOME ADDRESS:…………………………….……………………………………………............................................................

CONTACT ADDRESS:..……………………………………………………………………...........................................................

LOCAL GOVERNMENT OF ORIGIN:.......……………………………………………..............................................................

OCCUPATION:………………………………………………….....SEX..................................................................................

MARITAL STATUS:…………………………………………………………………………………………………………...................

NEXT OF KIN (NAME):………………………………………………………….................………………......................................

CONTACT ADDRESS:………………………………………………………………………………………………………..................

EXTRA CURRICULUM VITAE:..........………………………………………...........................................................................

POSITION:.............……………………………………………………….................................................................................

OATH OF ALLEGIANCE
I…………………………………………….solemnly vow to be loyal and faithful to the cause and duties of the Congress,
and always defend the fundamental rights of Edo people. So help me God.

Date:………………………………............ …………............... Sign:………………………………………...............................
QUARTERLY CONTRIBUTIONS:…………………………………………………………………………………..............................
(Physical, cash/materials)

OFFICIAL USE ONLY

SERIAL NUMBER:………………………………………………………………………………………………………….........................

C/C:.....………………………………………………………………………………………………………………...................................

RES/C:........………………………………………………………………….……………………………………...................................

G/S:.......……………………………………………………………………………………………………………………….......................

LG/C:........………………………………………………………………………………………………………………..............................

F/C:.......……………………………………………………………………………………………………………………............................

CAUTION
This is a statutory property of Benin National Congress, and it reserve the unequivocal privilege to invalidate the membership rights of any member whose conduct is deemed nefarious and at the same time violate the provisions of her Constitution.
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