Participant Form – NATIONAL INCOME ACTIVATION INITIATIVE (NIAI)

Participant Registration

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

WhatsApp Number *

Gender *

Date of Birth *

State *

LGA *

Residential Address / Community *

Occupation *

Education Level *

Digital Readiness

Social Media Handle *Paste your most active handle, e.g. "IG: @adaobi_nwa".

Internet Access Level *

I have access to a smartphone

I am willing to create promotional content

Skills & Experience

Current Skill or Trade *

Previous Training Received *

I currently sell products/services

I have online selling experience

I have offline selling experience

I am willing to learn

Sector of Interest

Sector of Interest 1 *

Sector of Interest 2 *

I am open to assignment to any vendor

Financial Inclusion

Bank Account Status *

Bank NameRequired if you have a bank account. Leave blank if you selected "No account yet" above.

Account NameRequired if you have a bank account. Leave blank if you selected "No account yet" above.

Account NumberRequired if you have a bank account. Leave blank if you selected "No account yet" above.

BVN/NIN Availability *

Fintech Platforms Used *

Activation Readiness

I am available for the full 90-Day Pilot

Weekly Hours Available *

I commit to attending orientation

I commit to weekly reporting

Vendor Preference

1st Choice Vendor *Your first preference. Staff use this to guide assignment — you are not guaranteed this vendor.

2nd Choice Vendor *

3rd Choice Vendor *

Relevant Experience *

I am willing to be reassigned if my choices are unavailable

Motivation

Why are you joining NIAI? *

Verification

National Identification Number (NIN) *Your 11-digit NIN. If you do not have one yet, you can get one from NIMC.

BVN Number (Optional)Only needed if you have a bank account. Leave blank if you don't.

Passport Photograph *Required. If the form comes back with an error, please re-attach this file — browsers do not keep file selections after a page reload.Clear head-and-shoulders photo, JPG or PNG, max 5 MB.

Government ID Upload *Required. If the form comes back with an error, please re-attach this file — browsers do not keep file selections after a page reload.

Referral Source *

Consent & Declaration

I declare the information provided is accurate *

I consent to be contacted by NIAI and its vendors/partners *

I consent to weekly monitoring during the pilot *

I acknowledge that NIAI is not a grant or loan program *

Please submit your application only once. Multiple submissions may delay your review or disqualify duplicate entries.

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Participant Registration

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