AFDIN · Registration for Farmers with Disability

Full Name *

State *

LGA *

Ward *

Phone number *

11 digits, e.g. 08012345678

Age *

Type of Disability *

Physical / mobility Visual impairment Hearing impairment Speech / communication Intellectual / learning Multiple

Other (specify):

Select all that apply

NIN (National ID Number) *

11 digits, found on your NIN slip

Your information is protected