Federation of Global Diplomacy Membership Registration
Name
*
First Name
Last Name
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
Country of Residence
*
Please indicate the Country where you live.
Full address
*
WhatsApp Number
*
Please enter a valid WhatsApp phone number.
Regular Number
*
Please enter a valid Regular phone number.
Occupation
*
Please indicate your occupation
Educational Background
*
Please Select
Junior High Student
Senior High Student
High School Graduate
College Student
College Graduate
Vocational Training Certificate/ Diploma
Master
PhD
Are you a member of any Organization?
*
Please Select
Yes
No
Name of Organization.
*
Indicate the Organization you are a member of.
Your Position
*
Indicate the your role within the Organization you are a member of.
Categories of Membership
*
Please Select
Student Membership
Honorary Membership
Individual Membership
Organization/Corporate Membership
Why do you want to become a member of the Federation of Global Diplomacy? (100 words)
*
Note: Your registration fee goes towards the day to day operations of the Federation? Do you agree?
*
Please Select
Yes
No
Do you agree to pay a membership Registration fee of USD $ 10.00? Note: Ten United States Dollars for Liberian Nationality only which is being classified by the Secretariat based on your Membership Category
*
Please Select
Yes
Do your registration through the Below Mobile Money Number 0880835002-Patience Siaker and send a screenshot to the same number on WhatsApp to prove your registration
*
Please Select
Yes
No, in Person
Will you be willing to support the Federation Financially and Morally at all times?
*
Please Select
Yes
No
Who can we contact in case of Emergency?
*
Name of Emergency Contact Person
Relationship between you and the Emergency Contact person?
*
Indicate the relationship with the Contact Person
Please indicate the phone numbers of the Emergency contact person?
*
Phone Number of the Emergency contact person.
Please indicate the email addres of your emergency contact person
Email address of your emergency contact person.
By filling this form you agree to abide by every rule and regulation of this Federation to support and promote the image of this Federation and to protect the value and moral of this Federation.
Please Select
Yes
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