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Member Registration
Quungana Welfare Association
Update Existing Records
Step 1: Principal
Step 1 of 4: Principal
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1
Principal
2
Dependants
3
Beneficiaries
4
Review
Principal Information
Required
Member ID Number
Member ID Number
Group Name
Group Name
Group Number
Group Number
Title *
*
Title * *
First Name *
*
First Name * *
Last Name *
*
Last Name * *
Middle Name
Middle Name
ID Type *
*
ID Type * *
ID Number *
*
ID Number * *
Date of Birth *
*
Date of Birth * *
Age 18-69
Gender *
*
Gender * *
Country *
*
Country * *
City *
*
City * *
Address *
*
Address * *
Phone Number *
Phone
Email *
*
Email * *
All fields marked with * are required.
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