CNG DISTRIBUTION REGISTRATION FORM

 

COMPLETE THE FORM BELOW IF YOU HAVE NOT YET REGISTERED

- Surname:  

- First Name:  

- Gender:  

- Date of Birth:  

- Home Address:  

- Phone Number:  

- NIN:  

- Email:  

Highest Qualification:  

- SSCE, OND, NCE, HND, BSC...  

Course of Study:  

Institution:  

Can you drive?:  

- Year of Driving License:  

- Or, I don’t have a driving license:  

- License Number:  

Religion:  

State of Residence:  

Residential Address:  

State of Birth:  

Local Government of Birth:  

Father’s Name:  

Mother’s Name:  

Guarantor’s Name:  

Phone Number:  

Email:  

After successful registration, a screenshot of your details will be sent to your email.

Registration Fee and Submission: ₦2000