Registration form Upload passport *Will be used to for your Membership IDChoose FileNo file chosenDelete uploaded fileFirst Name *Last Name *Age *Gender *Choose oneMaleFemalePhone *WhatsApp-enabled preferredEmail Address *Country of operations *NigeriaState of operation *SelectAbiaAbuja (FCT)AdamawaAkwa IbomAnambraBauchiBayelsaBenueBornoCross RiverDeltaEbonyiEdoEkitiEnuguGombeImoJigawaKadunaKanoKatsinaKebbiKogiKwaraLagosNasarawaNigerOgunOndoOsunOyoPlateauRiversSokotoTarabaYobeZamfaraRegistration Category *SelectIndividualCorporatePrimary Role *SelectCrop FarmerLivestock FarmerAquaculture FarmerAgro-processorInput Supplier (seeds, fertilizer, etc.)Aggregator / Off-takerDistributor / TraderLogistics ProviderExtension OfficerAgritech Service ProviderOther (specify)Agribusiness registered name *Is your agribusiness registered with CAC *SelectYesNoBriefly describe your organisations products/services *What payment have you made? *SelectN22,000 - Registration fee and full annual duesN16,000 - Registration fee and 1st instalment of annual duesWhat payment have you made? *SelectN50,000 - Registration fee and full annual duesN38,000 - Registration fee and 1st instalment of annual duesUpload payment receipt *PDF onlyChoose FileNo file chosenDelete uploaded fileConsent *Consent to data collection and use for program developmentConsent *Consent to be contacted by GSAI and partnersHow did you hear about GSAI-BFV? *SelectSocial mediaGSAI websitePeer recommendationothers (Please specify)Submit
