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Membership Application
Fill in the form below to apply for UG membership
Download Blank Membership Form (PDF)
Full Name
Email Address
Phone Number
Must be exactly 10 digits (no spaces or dashes)
NRC
Department
Province
-- Select Province --
Central
Copperbelt
Eastern
Luapula
Lusaka
Muchinga
Northern
North-Western
Southern
Western
District
-- Select District --
Ministry
Work Station
Employee Number
Name of Recruiter
Contact of Recruiter
Completed Membership Form (PDF, JPG, PNG)
Max file size: 10MB
Latest Payslip (PDF, JPG, PNG)
Max file size: 10MB
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