REGISTRATION FORM

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Password^*

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Enter password again^*

Password must be at least 7 characters long.

First Name^*

Last Name

Email^*

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Male
Female

Date of Birth

Contact Information

Residential Address

Address Line 2

Country

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Email Address

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Next of Kin

First Name

Last Name

Surname

Address

Phone Number

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Bank Details

Bank Name

Bank Account Name

Bank Account Number

Administrative Information

Membership Type

Elite Partner ( N225,900)
Partner ( N37,650)
Consultant (N1,650)

Declaration

I hereby affirm that information provided above for my partnership with Partner With Us™ and  her strategic Real Estate partners are true and accurate.

I affirm

Referred by^*

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Email Address^*

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Having submitted the registration form, please pay the appropriate membership or partnership fee to PHPAC Ltd, and mail the scanned copy of the bank teller and soft copy of your clear passport photograph to: info@partnerwithus.org, partnerwithus.org@gmail.com When you’re done with the sending of the payment teller and your passport to the email address provided, kindly call/whatsApp us on +234 802 777 5969, 01 290 3949 See or save the account details below:

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REGISTRATION FORM

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