Nigeria Please enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth *Gender *MaleFemale Name LGA Email Email *Phone Number *LGA of Origin *AbakAkamkpaAkpabuyoBakassiBiaseCalabar MunicipalCalabar SouthEastern OboloEketEsit-EketEssien UdimEtim-EkpoEtinanIbenoIbesikpo-AsutanIbiono-IbomIkaIkonoIkot AbasiIkot EkpeneIniItuMboMkpat-EninNsit-AtaiNsit-IbomNsit-UbiumObot-AkaraOdukpaniOkoboOnnaOronOruk AnamUdung-UkoUkanafunUruanUrue-Offong/OrukoUyoSubmit
