First Timer

Surname (required)

First Name (required)

Other Names (required)

State Of Origin (required)
---AbiaAdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfara

L.G.A (required)

Place OF Birth (required)

Town/Village (required)

Date Of Birth (required)

Phone Number (required)

Are You Born In A Christian Home?
YesNo

If Your, Your Church Of Birth (required)

Have You Been Immensionaly Baptised? (required)
YesNo

Marital Status (required)
MarriedSingleDivorcedWidowed

Is Your Union Blessed In A Christian Rite? (required)
YesNoI am not married

Under Which Church Did You Perform Your Holy Matrimony?

How Many Children Do You Have?

Occupation

Position In Place of Work

Are You A Student?
YesNo

If Yes, Name of Institution

Previous Church Attended

Reason Why You Left The Church

Why Did You Join LGGPM

Who Invited You

What Are Your Aims/Vission Towards LGGPM