MEMBERSHIP FORM

Fill the form below and we will get back to you shortly , or contact us at
member@disabledcentre.org
First Name: *
Last Name: *
Office Address: *
Home Address: *
Postal Address:
Phone: *
E-mail: *
Type of Membership
Monthly aid to the centre: Currency
 

Bank Account Details
Account Name:
Centre for the empowerment of the disabled
Bank: Oceanic Bank PLC, Apata Street Shomolu, Lagos
Account Number: 1201005934

 
 
 
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