Membership Registration – Quest Ghana Mall

Name *

First

Last

Town/City of Residence *

Region of Residence *

Home Address *

(include neighbourhood, street address and house number)

Email *

Phone *

Company Name *

Town / City *

Workplace Address *

Upload Signed and Scanned ID Card (Voters, National ID, Passport, Driver's License) *

Click or drag a file to this area to upload.

Scan, print, sign, and then scan and upload the scanned softcopy here.

Upload Passport Picture *

Click or drag a file to this area to upload.

Your photo should be taken against a white background. Size: 35mm x 45mm. Must be a recent photo, taken within the past 6 months.