REGISTRATION FORM

Designation *
Surname *
Other Names *
Gender *
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Department *
PF No. *
National ID *
Permanent Address *
Jkuat Email Address *
Mobile No *
Date of Employment *
Next of kin full Names *
Next of kin contacts (Permanent Address and Mobile Number) *
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Date *
FOR OFFICIALS USE ONLY
Sign ............................................Date................................UASU JKUAT CHAPTER CHAIRMAN
Sign.............................................Date................................UASU JKUAT CHAPTER SECRETARY