MEMBERSHIP REGISTRATION – MOUVMAN SESELWA RASIN
NATIONAL IDENTIFICATION NUMBER: _________________________
LAST NAME : _________________________________________________
NAME: _________________________________________________
date: ____________________________________________
ADDRESS: ____________________________________________
_____________________________________________
_____________________________________________
Email Address (If any): _________________________________
DISTRICT WHERE YOU ARE REGISTERED TO VOTE: ________________
THE UNDERSIGNED, on the date and year written above, do hereby, of my own free will and volition, join the Mouvman Seselwa Rasin.
SIGNATURE: ________________________
PRINT NAME: ________________________
INSTRUCTIONS
Please complete the form by filing in each area indicated. Write you name in block capital letters below the signature line. Sign the form.
After the form is completed and signed, mail a copy to:
Mouvman Seselwa Rasin; Anse Takamaka, Praslin; Republic of Seychelles
If you have a scanner, scan the completed form and attach it to an email and email it to seselwarasin@gmail.com. And WELCOME TO THE MOUVMAN.
