MEMBERSHIP REGISTRATION FORM

MEMBERSHIP REGISTRATION FORM

CATEGORY OF MEMBERSHIP Please tick (✓) as applicable:

Individual

Corporate Body

Group Member (Association/Community/Institution

First Name

Last Name

Phone/Mobile

Whatsapp Number

Email

Birth Date

Nationality

Address

Address

City

State

Gender

Male

Female

Others

Occupation / Profession

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I/We hereby declare that the information provided above is true and correct to the best of my/our knowledge. I/We agree to uphold the principles of: Lawful civic engagement Non-partisanship Integrity and accountability Respect for constitutional order Peaceful advocacy I/We understand that membership does not confer law enforcement authority and that all activities shall comply with applicable laws and institutional guidelines.

Signature

First Name

Last Name

Date / Time

MEMBERSHIP BENEFITS

Registered Members & Partners may benefit from:

Participation in national awareness programs
Institutional recognition
Networking with local and international stakeholders
Access to security literacy workshops
Involvement in humanitarian outreach initiatives
Certificate of Membership / Partnership

Call:

+234-9031451411
+234-8093000015
+234-9099993044

Mail for information:

001@afriempire.org
noreply@afriempire.org

Address Abuja, Nigeria

Contact with us +234-9031451411

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