Register for MDAP (NHIS/ANAC)

OPTION #1: APPLY ONLINE

Fill out the following form to apply online for benefits of MDAP . MDAP coverage includes
discount and pharmcy cost for health care coverage in the USA.

Name:

Address:

City:

State/Provence:

Country:

Zip/Postal:

E-Mail:

Phone Number:

Agent Number (if known):


Type of Membership (select one):

Individual -- $270 per year

Family-- $375 per year

Large Family -- $480 per year


Additional Comments/Suggestions:



OPTION #2: APPLY BY PHONE

Your application can be processed quickly over the phone. Have your credit card and information ready and call one of our representatives at:

301-423-4834 or
202-496-5307


OPTION #3: APPLY BY MAIL:

If you prefer you may instead simply download our form and print it out on your printer. Insert the form in an envelope and mail it to:

All Nigeria American Congress
P.O. Box 6500
Largo, MD 20792

Click here to download the form if you are an Individual or Family

Click here to download the form if you are an Organization

 
Donald Payne

U.S. Congressman
(Committee Africa
& International
Relations)
Keynote:
Economic and
Anti-Corruption
Town Hall Meetings




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