MEMBERSHIP FORM

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MEMBERSHIP FORM

Please Note: Your Name with SW should be the exact name you have with your bank

CODE *

DATE *

YYYY

Surname *

First Name *

Middle Name

Address *

Location (City/State) *

Date of Birth *

YYYY

NUMBER OF SLOTS *

I SLOT N52K: Own your car within 9 to 12months

3 SLOTS: N156K: Own your car within 6 to 9months

7 SLOTS: N364K: Own your car within 4 to 6months

WHATSAPP NUMBER *

PHONE NUMBER *

NEXT OF KIN

Please fill in the details of your next of kin below

NAME *

RELATIONSHIP *

PHONE NUMBER *

MAKE PAYMENT TO

FIDELITY BANK
Account Name: SWIFT INITIATIVE FOR POVERTY ERADICATION
Account Number: 5600505372

ZENITH BANK
Account name: Swift Initiative For Poverty Eradication
Account Number: 1017030613

To confirm your payment please call 08133303740 or 08168431535

Submit

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