ACCRA MALL

ACCRA MALL

ACCRA MALL
REGISTRATION FORM
Name

First NameLast Name
Email
example@example.com
Country

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Town
REGION
Phone Number

Area CodePhone Number
Gender
Date

MonthDayYear
Date
Type of work
Form fee payment =GHC 100 (MTN MOBILE MONEY)
Mobile Money Payment Account Details:

Payment Number: 0245799763

Account Name: JUSTICE GBEKU

NB: After payment send us your Full name and Valid Phone Number
Snap a passport picture
Signature
Should be Empty: