Registration Type
Individual or Group
Personal Info
Name, DOB, Gender
Contact Info
Email, Phone, Address
Location Info
State, LGA, Ward
Youth Group / Group
Join or Register Group
Guardian / Next of Kin
Emergency contact
Uploads
Photo & ID
Completed
Registration successful
Registration Type
Choose whether you are registering as an
Individual
or a
Group
.
Select Type
Select...
Individual
Group
Personal Information
Enter your personal details.
Profile Picture
Title
Select...
Mr
Mrs
Miss
Ms
Dr
Prof
Chief
Engr.
Pastor
Rev.
Hon.
Sen.
Surname
First Name
Other Name(s)
Date of Birth
Gender
Select...
Male
Female
Marital Status
Select...
Single
Married
Divorced
Widowed
Contact Information
Provide your contact details.
Email
Phone Number
Address
Occupation
Select...
Accountant
Administrator
Architect
Artist
Business Owner
Civil Servant
Consultant
Doctor
Driver
Engineer
Entrepreneur
Farmer
Health Worker
Journalist
Lawyer
Lecturer
Manager
Nurse
Pharmacist
Pilot
Police Officer
Politician
Student
Teacher
Trader
Unemployed
Other
Specify Occupation
Education Level
Select...
No Education
Primary School
Junior Secondary School (JSS)
Senior Secondary School (SSS)
National Certificate of Education (NCE)
National Diploma (ND)
Higher National Diploma (HND)
Postgraduate Diploma (PGD)
Bachelor’s Degree
Master’s Degree
PhD / Doctorate
Location Information
Select your State, LGA and Ward.
State
LGA
Select LGA
Abua–Odual
Ahoada East
Ahoada West
Akuku-Toru
Andoni
Asari-Toru
Bonny
Degema
Eleme
Emohua
Etche
Gokana
Ikwerre
Khana
Obio-Akpor
Ogba–Egbema–Ndoni
Ogu–Bolo
Okrika
Omuma
Opobo–Nkoro
Oyigbo
Port Harcourt
Tai
Ward
Select Ward
Group / Youth Group Information
Fill in depending on your type.
Youth Group
Select Group
Group Name
Group Leader Name
Download Member Template
Download Member Template
Upload Filled Member List
Guardian / Next of Kin
Depends on age.
Guardian Name
Guardian Phone
Relationship
Select...
Father
Mother
Brother
Sister
Uncle
Aunt
Grandparent
Guardian
Other
Next of Kin Name
Next of Kin Phone
Relationship
Select...
Spouse
Child
Father
Mother
Brother
Sister
Uncle
Aunt
Grandparent
Friend
Other
NIN Verification
Provide your National Identification Number (NIN) for verification.
Enter NIN
NIN must be exactly 11 digits.
Upload NIN Slip (Optional)
You're Done!
Your youth membership application has been submitted.
You will receive an email/SMS once your registration is approved.
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