Membership Registration Form
Personal Information
Select Title
Mr
Ms
Dr
Engr
Prof
Please select a title.
Surname is required.
Other Name is required.
Select Gender
Male
Female
Other
Please select gender.
Date Of Birth
DOB is required.
Address required.
Country is required.
State of origin required.
Telephone required.
Post code required.
Valid email required.
Mobile number required.
Area of operations required.
Select Category
MILT
CMILT
FCILT
ASS MEM
AFF
Category required.
Select Branch
Lagos
Abuja
Ibadan
Kano
Calabar
Lokoja
Port Harcourt
Owerri
Oron
Uyo
Warri
Zaria
Branch Required.
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Organization Details
Organization name required.
Organization address required.
Job title required.
Select ID Type
National ID Card
Voter's Card
International Passport
ID type required.
Document number required.
Date Appointed
Appointment date required.
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Referees
Referee 1 name required.
Referee 1 branch required.
Referee 1 title required.
Referee 2 name required.
Referee 2 branch required.
Referee 2 title required.
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Documents Upload
Passport Upload
O Level Certificate
Bachelor Certificate
Master Certificate
Phd Certificate
Professional Certificate
Short Courses Certificate
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Review & Consent
Select Payment Channel
Remita
Payment Channel required.
I confirm all information is true
Please confirm.
Submit & Pay
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