Membership Form (Formulaire D'Adhesion)
Surname (Nom):
Firstname (Prénom):
Date of Birth (Date de naissance):
Place of Birth (Lieu de naissance):
Nationality (Nationalité):
Ghana
Nigeria
Senegal
Algeria
Angola
Benin
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Congo
Democratic Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Eswatini
Ethiopia
Gabon
Gambia
Guinea
Guinea-Bissau
Ivory Coast (Côte d'Ivoire)
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Rwanda
São Tomé and Príncipe
South Africa
South Sudan
Sudan
Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
National Identity (Carte d'identité nationale):
Upload Back of Card (Télécharger l'arrière de la carte):
Profession (Profession):
Residence Address (Adresse du domicile):
Email (E-Mail):
Mobile Phone Number (Numéro de téléphone portable):
I swear that all the information given are true (Je jure que toutes les informations données sont vraies):
Submit / Soumettre