Registration Form
First Name*
Last Name*
Select Gender
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Select Marital Status
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Date of Birth (dd/mm/yyyy)
Email Address
Mobile Number (260xxxxxxxxx)*
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Select Education Level
Higher Education
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Select Category
General Membership K240 Per Year
Group Membership K500 Per Year
Life Membership K600 Per Year
VIP K1,200 Per Year
Youth Membership K120 Per Year
Select Committee
Agriculture
Education And Home economics
Fundraising
Health and Environment
Marriage and Family
Peace and Prosperity
Public Relations
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