Membership Registration Form

Anchor Real Estate Group

Cooperative Society Limited

Please complete every section. Fields marked * are required. You will need a recent passport photograph.

1Personal & employment information

Passport photograph *Tap to upload

Recent, head and shoulders, plain background. JPG or PNG.

Surname *

First name *

Other names

Date of birth *

Marital status *

Office address *

Office location / department *

Mobile phone number *

Include the network code, e.g. 0803…

Email address *

2Next of kin details

Name *

Relationship *

Address *

Telephone *

3Financial & contribution setup

Monthly contribution *

To be deducted from your salary.

Effective date of contribution *

Bank name *

For app withdrawals and loans.

Account number *

10 digits.

4Digital platform consent

I consent to having my profile created on the Anchor Cooperative mobile application to access my Savings, Loans, Purchases, and Shares.I agree to the setup of a Digital ID and biometric login for application security.

5Declarations & signatures

I hereby declare that the information provided above is accurate and true. I agree to abide by the bye-laws and regulations governing the Anchor Real Estate Group Cooperative Society Limited. *

Applicant signature *

Type your full name. It stands as your signature.

Date

20 Oct 2026

Witness details

Optional here. Your witness signs the printed copy of this form.

Name

Address

Payment instructions

Pay the non-refundable registration fee of ₦20,000 to:

Bank: First City Monument Bank (FCMB)
Account name: Anchor Real Estate Group Cooperative
Account number: 1052083039

The “Official use only” part of the form is completed by the Secretariat.