PBO Registration

You are referred by HAPPINESS AMAKOR (happinessikonne@gmail.com) and will become a member of his/her network.

PERSONAL INFORMATION

Do you have a Referral Link?^*

Center

Referrer/Sponsor Phone No

This should be filled only if you don’t have a referral link.

Referrer/Sponsor ID

This should be filled only if you don’t have a referral link.

Is the Title Owner a Company?^*

Title Owner Full Name^*

Desired name for property title preparation

First Name^*

Last Name^*

Gender^*

Male
Female

Date of Birth^*

Email^*

Confirm Email Address

Enter your email address again

Passport Photo (Max 1MB)

Please upload your passport photo. Allowed file types are jpg, jpeg, png, pdf

Signature (Max 1MB)

Please upload your signature. Allowed file types are jpg, jpeg, png, pdf

Contact Address

Street Address 1 ^*

Street Address 2

City ^*

State or Region ^*

Country ^*

Zip

Phone Number ^*

NEXT OF KIN

Nok First Name^*

Nok Last Name^*

NoK Phone Number(s)^*

Nok Email Address^*

Nok Relationship^*

Nok Contact Address

BANK DETAILS

Bank

Other Bank

Account Name

Account Number

AFFILIATE SELECTION

Select Affiliates

Select from the list of affiliates the one(s) you wish to purchase your home from.

Hold down the ctrl key and click to select multiple affiliates

AffiliatesPress ctrl or ⌘ (in Mac) while clicking to select multiple options.

HOME PAYMENT PLAN

Have You Paid Your First Installment?

Amount Paid

Date of Payment

Bank Paid Into

Account Number Paid Into

Payer’s Name

Monthly Payment Plan

These are 100 possible ways to subscribe. If required you can indicate your preferred amount by selecting “Other” at the bottom of the list.

Preferred Installment Amount You Want to Pay

Payment Duration

Do you Wish to Subscribe for a Home Above N15m?

Select “Yes” if you are interested in subscribing for a home above N15m

Home Options Above 15m

If required you can indicate your preferred amount by selecting “Other” at the bottom of the list

Preferred Home Value

Please upload evidence of payment. Allowed file types are jpg, jpeg, png, pdf

Username & Password

Preferred Username^*

Enter your preferred username

Password^*

Password must be at least 7 characters long.

Terms & Conditions

Click here to read the Terms and Conditions

Please confirm that you have read and agree with the terms and conditions^*

Yes, I have and I agree

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