Member Web Portal
Complete Enrollment Form
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Scheme Type
(Tier 2 Individual Contributor)
(Tier 3 Individual Contributor)
General Info
First Name
Middle Names
Surname
Previous First Name
Previous Other Name
Previous Surname
Employer
Previous Employer
Staff ID
Date Of Birth
SSNIT Number
Personal ID (Ghana Card Only)
Gender
Choose Gender
Male
Female
Marital Status
Choose Marital Status
Single
Married
divorced
Widowed
Previous Trustee
Security Question
Choose Question
In what city were you born?
What is the name of your favorite pet?
What is the name favorite High School Teacher?
What is your mother's maiden name?
Security Question Answer
Country Of Birth
Address Info
Email
Email 2
Mobile No
Mobile No 2
Residential Address
Mailing Address
Next Of Kin
Full Name
Relationship
Contact Mobile No
Email Address
Residential Address
Personal ID Number (Ghana Card Only)
ID Info
ID Number
ID Type
Choose ID Type
National ID (Ghana Card)
Driver's License
Passport
Voter's ID
Issue Date
Expiry Date
ID Image upload (Front View)
ID Image Upload (Back View)
Beneficiary
Add Beneficiary
Full Name
Relation
Percentage(%)
Contact
Date Of Birth
Address
I do hereby agree that by checking the consent box, I am electronically signing this form and this check box can be used in the absence of my signature for this form. I also agree that all information provided are accurate and true.
Complete Enrollment Form
Enrollment Form Preview
GENERAL INFO
First Name
Middle Names
Surname
Previous First Name
Previous Other Name
Previous Surname
Employer
Previous Employer
Staff ID
Date Of Birth
SSNIT Number
Personal ID (Ghana Card Only)
Previous Trustee
Gender
Marital Status
Security Question
Security Question Answer
Country Of Birth
ADDRESS INFO
Email
Email 2
Mobile No
Mobile No 2
Residential Address
Mailing Address
NEXT OF KIN
NOK Full Name
NOK Relationship
NOK Contact Mobile No
NOK Email Address
NOK Residential Address
NOK Personal ID Number (Ghana Card Only)
ID INFO
ID Number
ID Type
Issue Date
Expiry Date
BENEFICIARIES
Full Name
Relation
Percentage(%)
Contact
Date Of Birth
Address
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