Online Application — AAA Cooperative Society

Auchi Allied Association Co-operative Limited

Registration / Membership Form

Zenith Bank: 1310765696 | This form costs ₦5,000

1. Personal Information

Surname *

Other Names *

Permanent Home Address

Primary Address *

Occupation *

Gender

Phone Number *

Email Address *

Date of Birth *

2. Identification

Means of Identification

NIN

3. Contribution

Monthly Contribution (₦)

4. Appointed Nominee (Next of Kin)

You may add up to two nominees. Percentages must total 100%.

a) First Nominee

Name

Percentage (%)

Relationship

Phone

Address

b) Second Nominee

Name

Percentage (%)

Relationship

Phone

Address

5. Declarations

I wish to be a member of the above named cooperative. I also agreed to abide by its rules and regulations. The particulars supplied above are true to the best of my knowledge. *

I understand that upon submission, an invoice of ₦5,000 (form fee) will be generated, which is non-refundable and must be paid before my application is reviewed. *

Please note that except business loan, no loan shall exceed thrice the total monthly savings of that member.