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ENROLLMENT

Application for CUFM Enrollment and Group Family Shield Cover

Fill the form below, get your Application ID and make your payment online / bank.





If you have previously enrolled and want to pay, CLICK HERE

YOUR SPONSOR


Do you have a sponsor?



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BIO DATA

Who is Insured


BENEFICIARY DETAILS



Beneficiary 1


Beneficiary 2

Please ensure that you confirm your Sponsor's Details Above before Submitting.





SELECT PAYMENT OPTION


* N250.00 transaction fees



PAYING TO THE BANK



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