APPLY TO JOIN US - Labour Party Nigeria

Labor Party Nigeria - United States Chapter

NATIONAL WORKING COMMITTEE - SELECTION GUIDELINES

Data Collection Instructions:

> Please enter the data as requested in CAPITAL LETTERS / UPPERCASE

> For the drop down cells, do not override the entries provided. Select as applicable

> Send the completed form to this email before the collection closing date.

LPUSADATA@gmail.com

Title: Dr/Mr./Mrs./Engr etc. *

First Name *

Surname / Last name *

Gender *

Street Number & Name *

City *

State *

Zip Code *

State of Residence in USA (if different from Contact Address)

State of origin In Nigeria *

Occupation / Profession *

Industry or Sector *

Phone Number *

Email Address *

Type of Organization or Group You Represent *

Name of Organization or Group You Represent *