Hey, there. Fill the details in each step to complete your pre-licensing request.

1

Applicant information

Personal information.

Full name ^*

Please select your means of identification? ^*

National Id (Ecowas / Ghana card)PassportHealth Insurance ID (NHIS)Birth Certificate

Phone / Mobile number ^*

Email address (Optional)

Residential address ^*

Digital address

Date of birth

Next of Kin's information.

Full name ^*

His/Her relation to you ^*

What is your next of kin's employment status? ^*

Ecowas/Ghana Card ID ^*

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