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BKSA
| STUDENTS ALLIANCE
Student Registration Form
Please fill in all required details accurately. All fields marked with
*
are mandatory.
Full Name
*
Full name should only contain letters and spaces.
Date of Birth
*
Please select a valid date of birth.
Gender
*
-- Select Gender --
Male
Female
Other
Please select a gender.
Email Address
*
Please provide a valid email address.
Phone Number
*
Phone number must contain 10-15 digits.
LGA of Origin
*
LGA of Origin is required.
State of Origin
*
State of Origin is required.
Residential Address
*
Address is required.
State of Residence
*
State of Residence is required.
Institution
*
Institution name is required.
Course of Study
*
Course is required.
Volunteer Position
*
-- Select Volunteer Position --
Director
State Coordinator
Deputy Coordinator
State Working Committee
Campus Coordinators
Campus Captains
Members
Please select a valid volunteer position.
Coupon Code
*
Coupon code is required for Members.
Enter the coupon code shared by your Campus Coordinator
Do you have Permanent Voter's Card?
(Check if yes, leave unchecked for No)
Submit Registration