Iman Ibom Angels Network

"*" indicates required fields

Name*

First Name Surname

Phone Number*

Email Address*

Village*

Ward*

Current Location*

Are you open to being engaged in any or all of the following ways:*

As a Mentor

As A Sponsor

As an Iman Ibom Angel

Renew-11

Others

Please outline how you desire to participate.*

Consent*

NOTE: Your details will not be shared with anyone; By accepting, you will have back end access to the Etinan State Constituency Database & you can reach out to anyone you chose to

I agree

Disagree

Please state reasons; send email to Uduak.Ekpo-Ufot@etinansc.com