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Please fill in details about your State of origin below
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  • Abia
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  • Cross River
  • Delta
  • Ebonyi
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  • Ekiti
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  • Gombe
  • Imo
  • Jigawa
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  • Kano
  • Katsina
  • Kebbi
  • Kogi
  • Kwara
  • Lagos
  • Nasarawa
  • Niger
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  • Somalia
  • South Africa
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Swaziland
  • Sweden
  • Switzerland
  • Syria
  • Taiwan
  • Tajikistan
  • Tanzania
  • Thailand
  • Togo
  • Tonga
  • Trinidad and Tobago
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  • Turkmenistan
  • Tuvalu
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Employment Information

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  • Self Employed
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Bank Account Details

Next Of Kin Information

...in case of death or insanity
Please select
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  • Online
  • Radio
  • Handbill
  • TV
  • Friend
  • Church
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I declare that every information provided above is correct to the best of my knowledge and I shall abide by the Bye laws and the policy (Terms and Conditions) of DOCIM (Enugu) Multi-Purpose Co-operative Society Limited.
 
Registration Form
 
DOCIM Multipurpose Cooperative Society
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Prevent Duplicate Entry
Form Submission is restricted
Your data has been successfully submitted. Thank you! To activate your registration, kindly pay a non-refundable fee of N4,000 into the payment detail below
Registration Form
DOCIM registration form
Step 1 of 5

Personal Information

Please select
  • Please select
  • Male
  • Female
Please select
  • Please select
  • Married
  • Single
  • Widow
  • Widower
  • Divorced
% Completed0
Your form of identification must be ANY of the following: the front and back of your (National ID, Driver’s License, Voter’s Card) or the data page of your International Passport
 

Residential Address

Fill in where you currently live
Please select
  • Please select
  • Abia
  • Adamawa
  • Akwa Ibom
  • Anambra
  • Bauchi
  • Bayelsa
  • Benue
  • Borno
  • Cross River
  • Delta
  • Ebonyi
  • Edo
  • Ekiti
  • Enugu
  • Gombe
  • Imo
  • Jigawa
  • Kaduna
  • Kano
  • Katsina
  • Kebbi
  • Kogi
  • Kwara
  • Lagos
  • Nasarawa
  • Niger
  • Ogun
  • Ondo
  • Osun
  • Oyo
  • Plateau
  • Rivers
  • Sokoto
  • Taraba
  • Yobe
  • Zamfara
Please select
  • Please select
  • Afghanistan
  • Albania
  • Algeria
  • American Samoa
  • Andorra
  • Angola
  • Anguilla
  • Antarctica
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Aruba
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bermuda
  • Bhutan
  • Bolivia
  • Bosnia and Herzegovina
  • Botswana
  • Bouvet Island
  • Brazil
  • British Indian Ocean Territory
  • Brunei
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cambodia
  • Cameroon
  • Canada
  • Cape Verde
  • Cayman Islands
  • Central African Republic
  • Chad
  • Chile
  • China
  • Christmas Island
  • Cocos (Keeling) Islands
  • Colombia
  • Comoros
  • Congo
  • Cook Islands
  • Costa Rica
  • Croatia (Hrvatska)
  • Cuba
  • Cyprus
  • Czech Republic
  • Congo (DRC)
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • East Timor
  • Ecuador
  • Egypt
  • El Salvador
  • Equatorial Guinea
  • Eritrea
  • Estonia
  • Ethiopia
  • Falkland Islands (Islas Malvinas)
  • Faroe Islands
  • Fiji Islands
  • Finland
  • France
  • French Guiana
  • French Polynesia
  • French Southern and Antarctic Lands
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Ghana
  • Gibraltar
  • Greece
  • Greenland
  • Grenada
  • Guadeloupe
  • Guam
  • Guatemala
  • Guinea
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Honduras
  • Hong Kong SAR
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Japan
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Korea
  • Kuwait
  • Kyrgyzstan
  • Laos
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libya
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Macao SAR
  • Macedonia, Former Yugoslav Republic of
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Mali
  • Malta
  • Marshall Islands
  • Martinique
  • Mauritania
  • Mauritius
  • Mayotte
  • Mexico
  • Micronesia
  • Moldova
  • Monaco
  • Mongolia
  • Montserrat
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • Nepal
  • Netherlands
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Palestine
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Poland
  • Portugal
  • Puerto Rico
  • Qatar
  • Romania
  • Russia
  • Rwanda
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Vincent and the Grenadines
  • Samoa
  • San Marino
  • Sao Tome and Principe
  • Saudi Arabia
  • Senegal
  • Serbia and Montenegro
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Swaziland
  • Sweden
  • Switzerland
  • Syria
  • Taiwan
  • Tajikistan
  • Tanzania
  • Thailand
  • Togo
  • Tonga
  • Trinidad and Tobago
  • Tunisia
  • Turkey
  • Turkmenistan
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom
  • United States
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Vatican City
  • Venezuela
  • Vietnam
  • Yemen
  • Zambia
  • Zimbabwe
% Completed0
Upload your utility bill that is dated not more than the last 6 months
 

Permanent Home Address

Please fill in details about your State of origin below
Please select
  • Please select
  • Abia
  • Adamawa
  • Akwa Ibom
  • Anambra
  • Bauchi
  • Bayelsa
  • Benue
  • Borno
  • Cross River
  • Delta
  • Ebonyi
  • Edo
  • Ekiti
  • Enugu
  • Gombe
  • Imo
  • Jigawa
  • Kaduna
  • Kano
  • Katsina
  • Kebbi
  • Kogi
  • Kwara
  • Lagos
  • Nasarawa
  • Niger
  • Ogun
  • Ondo
  • Osun
  • Oyo
  • Plateau
  • Rivers
  • Sokoto
  • Taraba
  • Yobe
  • Zamfara
Please select
  • Please select
  • Afghanistan
  • Albania
  • Algeria
  • American Samoa
  • Andorra
  • Angola
  • Anguilla
  • Antarctica
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Aruba
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bermuda
  • Bhutan
  • Bolivia
  • Bosnia and Herzegovina
  • Botswana
  • Bouvet Island
  • Brazil
  • British Indian Ocean Territory
  • Brunei
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cambodia
  • Cameroon
  • Canada
  • Cape Verde
  • Cayman Islands
  • Central African Republic
  • Chad
  • Chile
  • China
  • Christmas Island
  • Cocos (Keeling) Islands
  • Colombia
  • Comoros
  • Congo
  • Cook Islands
  • Costa Rica
  • Croatia (Hrvatska)
  • Cuba
  • Cyprus
  • Czech Republic
  • Congo (DRC)
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • East Timor
  • Ecuador
  • Egypt
  • El Salvador
  • Equatorial Guinea
  • Eritrea
  • Estonia
  • Ethiopia
  • Falkland Islands (Islas Malvinas)
  • Faroe Islands
  • Fiji Islands
  • Finland
  • France
  • French Guiana
  • French Polynesia
  • French Southern and Antarctic Lands
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Ghana
  • Gibraltar
  • Greece
  • Greenland
  • Grenada
  • Guadeloupe
  • Guam
  • Guatemala
  • Guinea
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Honduras
  • Hong Kong SAR
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Japan
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Korea
  • Kuwait
  • Kyrgyzstan
  • Laos
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libya
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Macao SAR
  • Macedonia, Former Yugoslav Republic of
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Mali
  • Malta
  • Marshall Islands
  • Martinique
  • Mauritania
  • Mauritius
  • Mayotte
  • Mexico
  • Micronesia
  • Moldova
  • Monaco
  • Mongolia
  • Montserrat
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • Nepal
  • Netherlands
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Palestine
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Poland
  • Portugal
  • Puerto Rico
  • Qatar
  • Romania
  • Russia
  • Rwanda
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Vincent and the Grenadines
  • Samoa
  • San Marino
  • Sao Tome and Principe
  • Saudi Arabia
  • Senegal
  • Serbia and Montenegro
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Swaziland
  • Sweden
  • Switzerland
  • Syria
  • Taiwan
  • Tajikistan
  • Tanzania
  • Thailand
  • Togo
  • Tonga
  • Trinidad and Tobago
  • Tunisia
  • Turkey
  • Turkmenistan
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom
  • United States
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Vatican City
  • Venezuela
  • Vietnam
  • Yemen
  • Zambia
  • Zimbabwe
 

Employment Information

Please select
  • Please select
  • Self Employed
  • Employee
 

Bank Account Details

Next Of Kin Information

...in case of death or insanity
Please select
  • Please select
  • Online
  • Radio
  • Handbill
  • TV
  • Friend
  • Church
  • School
  • Office
  • Others (please specify)
I declare that every information provided above is correct to the best of my knowledge and I shall abide by the Bye laws and the policy (Terms and Conditions) of DOCIM (Enugu) Multi-Purpose Co-operative Society Limited.
 
Registration Form

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