ASUSS MPCS LTD

Membership Registration Form

Personal Information

Title

Please select an option.

Full Name

Date of Birth

This field is required.

Marital Status

Please select an option.

Gender

Please select an option.

Phone

This field is required.

Address

This field is required.

State

Please select an option.

LGA

Please select an option.

Ward

Please select an option.

Area

Please select an option.

Work Information

Ministries Department and Agencies (MDAs)

Please select an option.

Office Address

This field is required.

Current Grade Level

Please select an option.

Date of First Appointment

This field is required.

Retirement Date

This field is required.

Next of Kin Information

Next of Kin Name

This field is required.

Next of Kin Relationship

Please select an option.

Next of Kin Address

This field is required.

Next of Kin Phone

This field is required.

Saving and Bank Information

Bank Account

This field is required.

Bank Name

Please select an option.

Saving Amount

Login Informmation

Password

Confirm Password

DECLARATION

Already a member?Login

Important Notice To All Our Existing Member

Existing Members are advised not to create a new account. Use your PSN as Username and Password. and Update All Necessary Informations

Existing member Login