Agricmedia Farmers Cooperative

Agricultural Investment Services

Become a member: Obtain application form (or download pdf form) or fill an online form to become a member of our Cooperative Society

Your Email [dynamictext your-email readonly "myemail"]	Occupation
Gender (required)	Marital Status (required)
Next of Kin	Next of Kin Address
Next of Kin Telephone

Financials A. Contributions:
Minimum Monthly Savings (NGN/USD)
B. Investment/Shares Optional Equity Contribution Applied For:	Amount
Nominee(s): Nominate a person or persons to whom your shares or interest shall be transferred to in the event of such member's death, incapacitated or becoming permanently insane
Nominee	Nominee Telephone
Nominee Address	Sharing Ratio
Your Bank Details
Bank Name	Account Number
Account Name	BVN
I have read and agree to the Terms and Conditions