National Association of Microfinance Banks (NAMB)

Conference & Annual General Meeting (AGM) Registration

Registration Form

Conference & AGM July 19 & 20, 2019

Name of Institution

Phone Number

Corporate Email

Street

City

Zone

State

Licence

Licence Category

Others (Please specify)

Nominated Participant

Surname

Middle Name

Other Name

Phone Number

E-mail Address

Birth Date

Gender

Designation

Proxy Participant
(Only Chairmen and Managing Directors Are Eligible To Attend Except Approved by Proxy).

Surname

Middle Name

Other Names

Phone Number

E-mail Address

Birth Date

Gender

Designation

Payment

Method

Amount

Non-Member Fee: N25,000.00
Member Fee: N20,000.00

Bank: FBN
A/c N0: 2006166591
National Association od Microfinance Banks