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M4N Membership Registration Form
First Name
Middle Name
Last Name
Age
18 – 35
36 – 45
46 – 65
66+
Gender
Gender
Male
Female
Other
Phone
Auto Address
(Required)
Country
Country of Residence
Custom Country
States
State of Residence
Custom States
City
LGA of Residence
Custom City
Ward
Choose the ward
Custom Ward
Email
Occupation
Choose an Occupation
Business/trade
Employee
Student
Are you interested in running for a political office in 2023?
Yes
No
May Be
If yes, which office?
In which state would you be vying for office?
Are you a member of a valid political party?
Yes
No
Undecided
If yes, which party
How would you like to support Kingsley Moghalu for President
Financial Donation
Political Mobilisation
In-kind Contribution
Volunteer for his Campaign
Would you like to lead this movement in your area?
Yes
No
May Be
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