Fòs Chanjman Nasyonal

Membership Form

Be part of the most open movement in the country

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First name *

Name *

Gender *

Date of birth

NINU Card *

Card number

Phone

Country of birth

Department of birth

Commune of birth

Education Level *

Occupation *

Profession

Country *

Department

District

Commune

Communal section

Address

I declare that I am not a member of any other political party and certify that the information provided is accurate and true.

I declare that I adhere to the values of Fòs Chanjman Nasyonal and express my desire to campaign in accordance with the party's principles.

J’accepte que Fòs Chanjman Nasyonal utilise ces données pour m’envoyer des informations.