Rajasthani Samaj Lagos   MEMBERSHIP APPLICATION FORM   Member Spouse Child 01 Child 02 Child 03 Family Name * Name * Blood Group ---A+A--B+B--AB+AB--O+O-- ---A+A--B+B--AB+AB--O+O-- ---A+A--B+B--AB+AB--O+O-- ---A+A--B+B--AB+AB--O+O-- ---A+A--B+B--AB+AB--O+O-- Birth Date (DD/MM) Ann Date (DD/MM)         Qualification       Company Name, Address (5 Lines Max) Email 01 * Email 02 Mobile Nos * Residence Address (5 Lines Max) Area Ajao Apapa Ikeja Ikorodu Ikoyi Ilupeju Lekki Ota Surulere VI Yaba Spouse Nos   India Address (5 Lines Max) City of Residence India Nos     Notes: 1. Form, when submitted, is sent to the Management for processing. Once the Management gives approval, you will be informed over the Phone/ Email. 2. Please pay the Fees only after Approval Confirmation. 4. Please obtain Receipts for all Payments. 5. In case, you have any suggestion or complaint, please Click Here to proceed.
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