INDEPENDENT MARKETERS

BAYIT PROPERTIES AND INVESTMENT LTD

Suite 24/26/28 Blessed Chuks Plaza,Franklass Rd Ojo,Lagos. 07032500306,09082997007

Email: info@bayitpropertiesinvestment.com, www.bayitpropertiesinvestment.com

BAYIT INDEPENDENT SALES AGENTS REGISTRATION FORM

Please Fill out Registration form below in block letters to be a registered INDEPENDENT SALES AGENT of BAYIT PROPERTIES AND INVESTMENT LTD

First Name

Middle Name

Last Name

Sex

Male

Female

Date of Birth

Marital Status

Single

Married

State Of Origin

LGA

Contact Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone Nos

NEXT OF KIN INFORMATION

First Name

Last Name

Address

Address Line 1

City

State

Country

Relationship

Phone No

BANK ACCOUNT INFORMATION

REFERRER ACCOUNT NO

BANK NAME

ACCOUNT NAME

ACCOUNT NO

SIGN/DATE

CONSULTANT ACCOUNT NO

BANK NAME

ACCOUNT NAME

ACCOUNT NO

SIGN/DATE

Declaration : I hereby affirm that the information given is truth and I shall abide by every rules and regulations guiding BISA

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BISA REGISTRATION

BAYIT PROPERTIES AND INVESTMENT LTD

BAYIT INDEPENDENT SALES AGENTS REGISTRATION FORM