Shackle Breakers Club Membership Registration Form

1

Full Name* This field is required.

Prefix

First Name

Surname

2

E-mail* This field is required.

Kindly insert a functional email address

3

WhatsApp / Phone Number* This field is required.Kindly ensure your country code comes first

Country Code

Phone Number

4

Key Contact Information* This field is required.Please be aware that whenever we request it, diaspora members who live outside of Nigeria or prospective members who intend to move abroad must show us proof of their residences outside of Nigeria and their eligibility to vote in Nigeria, such as a voter's card or NIN.

Street Address (Where Do You Currently Live?)

Street Address 2 (Where Do You Vote or Work?)

Current City of Residence

Your Geo-political Zone in Nigeria

Country of Residence

5

Do you have a Voter's Card?* This field is required.Just one response may be chosen.

Yes, I do

No, I don't

I do, but not collected from INEC

I do, but I can't find it again

I do, but it is defaced

Other

6

Kindly upload a valid identification card* This field is required.Preferably Voters Card, Driver's License or NIN, Int'l Passport page

Drag and drop files here

Select files to upload

Min. file size10.0KB,

Upload Voters Card / NIN

Accepted formats: JPG, JPEG & PNG

7

Take Selfie!* This field is required.Please click the "Snap Me" button to take a photo of yourself.

8

Desired Membership Category* This field is required.After completing the registration process, select the category to which you'd like to upgrade from the default FREE membership class.

Artisan Class - 1k Monthly Due

Business Class - 3k Monthly Due

Investor Class - 5k Monthly Due

9

Which of these do you currently belong to or have you joined in the past?* This field is required.

Social Club (Example Eko Club, Lions, Rotary, Sports Club)

Cooperative Society

Business / Investment Hub

Political Party (PDP, APC, APGA, LP, YPP & Others)

None of the Above

10

Why do you want to join the club?* This field is required.

To Make Connections ONLY

For Nation Building ONLY

For Financial Gains ONLY

All of the above reasons

11

Which of these tools are you most adept at using?* This field is required.

Laptop / Notebook

Tablet / iPhone / Android

Java Phone

I don't have any device

12

How proficient are you with your device?* This field is required.Choose based on level of proficiency, highest being 'perfectly' and lowest being 'I don't know how'

Perfectly

Very well

Well

I can try but need help

I don't know how at all

13

What's the preferred way to contact* This field is required.Select your preferred option from the list.

Phone

Email

SMS

Other

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1. Club Membership is available to anyone 18 years of age or older.

2. Prospective members are required to have a functional business plan or a mind for one.

3. Shackles Breakers Club International is a Social gathering of business people with political interests. There shall be no discrimination against any member based on age, gender, political party, religion or choice of opinion.

4. Loans shall be requested only after due requirements are met.

5. All members are required to have their business (product or service), talent or skills placed for patronage on the pinnacle platform.

6. Members may wish to patronise other opportunities available in the club or as provided by partnering organisations provided such will not infringe on their loyalty or business of other members.

7. You promise NOT to use to conduct any fraudulent or business activity or have more than one Member Account at any time.

8. All members MUST be law-abiding citizens of Nigeria either at home or in the diaspora. Any member found wanting may be expelled by the management.

9. Loan defaulters shall not be spared as all our activities are computerised.

10. Our loyalty is first to our country Nigeria but membership growth shall also be determined strictly by sincere loyalty to the club and its leadership.

11. Members shall obey all rules, regulations and privacy policy agreement provided by the leadership of the club in its best interest or by partnering agencies.

15

Have you read the rules of engagement carefully?* This field is required.

Yes, I have read, understood, and accepted the rules for membership.

16

Membership Code

17

Please verify that you are human* This field is required.

18

Once you submit your application, we will contact you shortly to complete your membership application.

You will automatically be redirected COMPLETE the application process on PINNACLE online platform where you will be required to create your MONTHLY MEMBERSHIP FEES account. After doing such, kindly ensure that you visit the prefilled email for verification of the account then try to login with your details on https://sb.pinnacle.ng

Thank you!