Back to Main Page
Payment via Bank transfer
2021 District Polio Seminar
Please enable JavaScript in your browser to complete this form.
Registering As
*
Select appropriately
A Club
A Rotarian
A Rotaractor
Club
*
Select your club appropriately
Rotaractor
Aba
Aba Blue River Garden
Aba Hiltop
Abakaliki
Abakaliki-South
Abak Metropolis
Abakpa Nike Community
Aba-Metropolitan
Aba Municipal
Abayi-Aba
Aguleri
Aladinma-Owerri
Alu City, Ikot Abasi
Awka
Awka Central
Awka G.R.A.
Awka Hybrid
Awka Metropolis
Awka Municipal
Awka-NAU
Awka-Smithtown
Awka Urban
Calabar
Calabar-Tinapa
Calabar-Unical
Eket
Eket Groove
Ekulu
Emene
Emene
Enugu
Enugu City Center
Enugu City Layout
Enugu Govt House
Enugu G.R.A.
Enugu Independent Layout
Enugu Metropolis
Enugu-Municipal
Enugu North
Enugu Topland
Eziama-Sunrise
Eziukwu-Aba
Hill-Top Calabar
Igbariam Gateway
Ihiala Municipal
Ikenegbu-Owerri
Ikom Central
Ikot Ekpene Metropolis
Maryland Enugu
Mbaise
New Haven
Njikoka, Abagana
Nnewi
Nnewi Central
Nnewi Urban
Nsukka
Obosi City
Obowo
Ogbor-Hill, Aba
Ohafia Central
Okigwe
Onitsha
Onitsha East
Onitsha Gateway
Onitsha GRA
Onitsha-Metropolis
Onitsha Royal
Osisioma Gateway-Aba
Owerri
Owerri Central
Owerri Cosmopolitan
Owerri Metropolitan
Owerri North
Trans-Ekulu
Ugep Urban
Ukwunwangwu
Umuahia
Umuahia Central
Umuahia Govt House
Umuahia North
Umudike Central
Umungasi-Aba
Uyo
Uyo Capital City
Uyo Metropolis
Uyo Municipal
Uyo Shelter Afrique
Uyo Urban
Igbariam Gateway
Nsugbe
Umunze Urban
Ogoja Metropolitan
Parklane
Oraifite
Email Address
*
Club President: Full Name
*
First
Last
Club President: Call Name
*
Club President: Mobile Number
*
Club Polio Chair: Full Name
*
First
Last
Club Polio Chair: Call Name
*
Club Polio Chair: Mobile Number
*
Full Name
*
First
Last
Call Name
*
Mobile Number
*
Upload Evidence of Payment
*
Click or drag a file to this area to upload.
Date of Payment (select correctly)
*
For quick validation of payment
Click to submit
Copyright © 2021 - Rotary International District 9142
Event Portal built by THEDGIT.COM
bonusverenx.com
