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AGM Registration
Note: You can only complete this registration form if have made payment. You will be required to upload evidence of payment to complete the registration.
Phone
Full name
*
Contact Email Address
*
Phone Number
*
NIS State Branch
*
Select NIS State Branch
Abia
Adamawa
Akwa Ibom
Anambra
Bauchi
Bayelsa
Benue
Borno
Cross River
Delta
Ebonyi
Edo
Ekiti
Enugu
FCT
Gombe
Imo
Jigawa
Kaduna
Kano
Katsina
Kebbi
Kogi
Kwara
Lagos
Nassarawa
Niger
Ogun
Ondo
Osun
Oyo
Plateau
Rivers
Sokoto
Taraba
Yobe
Zamfara
Are you an NIS Member?
*
Yes
No
Do you intend to Present Paper(s)?
*
Yes
No
NIS Status
*
Fellow
Member
Associate
Probationer
Student
Are you registering an accompanying person(s)?
*
Yes
No
NIS Short Code
Area of Practice
*
Private Practice
Government
Academics
Student
Other
Organization/Institution Name
Accompanying person 1 - Full Name
Accompanying person 2 - Full Name
Will you like to attend the Gala Dinner?
*
Yes
No
Enter Total Amount Paid (NGN)
*
Enter Date of Payment
*
Upload Proof of Payment
*
Please Check all Entries before Submitting
