Application Form

Surname
First Name
Other Names
Date of Birth
Residential Address
Occupation
Company Name
Office Address
Telephone Numbers
Email
Nationality
Next of Kin (Surname)
Other Names
Address (Next of Kin)
Size / No of Plots Required
Type of Houses required






Mode of Payment




Reason for purchase




All payments are to be made in bank draft payable in Lagos:

Name of Account: Lonerax Nigeria Limited
                     Banks: (i) Union Homes Savings and Loans Limited
                          (ii) Wema Bank Plc