CUIB ONLINE APPLICATION

CREATE ACCOUNT

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Please write your name following the order on your Birth Certificate.

Surname(s)

First Name

Last Name

Tip: Your name order will appear as follows:

Gender

Date of Birth

Place of Birth

Nationality

Valid Invalid (0-9,a-z only)

Phone Number

Username

Valid Invalid (0-9,a-z only)

Password

Confirm Password

Security Questions