Ghanaian Citizen Registration Form

Surname*

Other Names*

Previous Name*

Email*

Date of Birth*

Place of Birth (Town)*

Sex*

Male

Female

Marital Status*

Single

Married

Divorced

Widowed

Name of Spouse

Nationality*

Previous Nationality*

Passport Number*

Date of Issue*

Date of Expiry*

Place of Issue*

Occupation/Profession*

SL	Current Employer/ Institution Details	Period and Other Details
1	Name* Address* City* Province* Post Code*	Date From* Date To* Phone Number* Email* Program/Profession*

Address in DEFAULT* Province/ Territory* Post Code*

Mobile/Residential Phone No* Work Phone Number* Email*

Name*

Relationship* Phone Mobile* Email*

Address* Province/ Territory* Post Code*

Membership of Associations and Religious Affiliations* Evidence of citizenship*

Upload Recent Passport Size Photo *

(Note: Width:235px, Height:265px. PNG/JPG files)

Click here to compress JPG files

Upload Evidence Document *

(Note: PDF/JPG files. Size up to 250KB)

Click here to compress files