Silverbird Group User Registration

STAFF Registration Form

USER INFORMATION

Title

Surname

First Name

Middle Name

Maiden Name

Upload Photo Passport

Date of Birth

Place of Birth

State of Origin

Local Government Area

Nationality

Gender

Marital Status

Religion

Contact Address

City

State

Email Address

Password

Phone Number

Pension Pin

Pension Provider

PROFESSIONAL/EDUCATIONAL HISTORY
Fill as Applicable

Highest Qualification

Primary School

Secondary School

First Tertiary Education

Second Tertiary Education

Third Tertiary Education

Professional Qualifications

NEXT OF KIN

Name

Relationship

Address

Telephone Number

Emergency Contact Number

GUARANTORS
Information of First Guarantor

First Name

Surname

Other Name

Residential Address

Business Address

Telephone Number

Information of Second Guarantor

First Name

Surname

Other Name

Residential Address

Business Address

Telephone Number