MEDLAB
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Membership Registration
Join the MedLab Cooperative and start your journey to health and wealth.
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Select Membership Type
Registration Category
Select a category...
Active Member
Shareholder
Consultant
Corporate Partner
How did you hear about us?
Social Media
Existing Member
Radio/TV Advert
Other
Personal Information
Full Name
Gender
Select...
Male
Female
State of Origin
Local Government (LGA)
Contact & Address
Email Address
Phone Number
Home Address
Cooperative Structure
State Apex
Union
SNC 1
SNC 2
Financial Profile
Bank Name
Account Name
Account Number
Next of Kin Information
Next of Kin Full Name
Relationship
N.O.K Phone Number
N.O.K Address
I certify that all information provided is accurate.
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Submit Registration