Baŋsim Chuɣu REGISTRATION FORM Bansim PERSONAL INFORMATION Applicant’s Name * Applicant's Name Surname Surname First First Date of Birth * District * Gender * Male Female Marital Status * Single Married Profession * Email * WhatsApp Contact * Alternate Phone Digital Address * Payment Reference * GUARANTOR’S INFORMATION Name Name Surname Surname First First Profession Phone Email District Motto: Wuhimi A Dagbanli Milinsi If you are human, leave this field blank. Submit Δ