ZOGHORI SACCO MEMBERSHIP APPLICATION FORM

ZOGHORI SACCO MEMBERSHIP APPLICATION FORM
I hereby apply to be considered for enrolment in ZOGHORI SACCO SOCIETY LTD and agree to conform to the Society's By-Laws and any amendments thereof.
TAKE PASSPORT SIZE PHOTO:*
1. PERSONAL PARTICULARS
FULL NAME:*
DATE OF BIRTH:*

MonthDayYear
Date
I D/PASSPORT NO.:*
ID/PASSPORT NUMBERS
TAKE PHOTO OF FRONT-FACE OFYOUR ID:*
TAKE PHOTO OF BACK-FACE OF YOUR ID:*
SELECT YOUR MARITAL STATUS:*

SingleMarriedWidowWidowerDivorced
ENTER YOUR KRA PIN
2. EMPLOYMENT DETAILS:
SELECT TYPE OF EMPLOYMENT*
NAME OF EMPLOYER (IF FORMALLY EMPLOYED):
TYPE OF BUSINESS (IF SELF-EMPLOYED):
POSITION IN EMPLOYMENT/BUSINESS:
EMPLOYER'S/BUSINESS ADDRESS:
PHYSICAL ADDRESS*
HOME ADDRESS:
CURRENT ADDRESS*
MOBILE/PHONE NO.(MPESA)*
MOBILE/PHONE NO.(2)
ENTER YOUR EMAIL ADDRESS:*
example@example.com
SELECT YOUR NEAREST OFFICE LOCATION*
APPLICANT'S SIGNATURE*
NOMINATED NEXT OF KIN DETAILS:

I, the undersigned, in the event of my death whilst a member of the society, hereby instructs the Society to pay all amounts due to me less any debts to the society, to the person(s) named in this Section. I understand that I may alter the name of nominated Next of Kin by filling in a subsequent Nominated Next of Kin Form. (The name of your nominee can be given in a sealed envelope)

NEXT OF KIN DETAILS:*

UPLOAD COPIES OF ID/BIRTH CERT OF NEXT OF KINS

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TAKE PHOTO OF COPY OF ID/BIRTH CERT.(NEXT OF KIN)
TAKE PHOTO OF COPY OF ID/BIRTH CERT.(NEXT OF KIN)
TAKE PHOTO OF COPY OF ID/BIRTH CERT.(NEXT OF KIN)
ACKNOWLEDGEMENT:

I hereby acknowledge having read and understood the SACCO BY-LAW and the MEMBERSHIP POLICY BOOKLET and I confirm the conditions and guidelines have been well explained to me and that I understand the contents hereof and I accept the terms of the document for the time in force. I also accept that the terms of this document may change and that I shall be bound by such changes as are communicated to the members from time to time.
APPLICANT'S SIGNATURE*

REFEREE:

	NAME	MEMBER NO.	ID NO.
1.

REGISTRATION FEE PAID ON:*

MonthDayYear
enter date you made registration fee payments.
ENTER M-PESA TRANSACTION CODE:*
DATE OF MEMBERSHIP APPLICATION:*

DayMonthYear
Date
PAYMENT METHODS

MOBILE BANKING PROCESS

FOR MOBILE BANKING USE PAY BILL BUSINESS NO. 4077167 AND ENTER YOUR IDNO#CA AS THE ACCOUNT NUMBER.
- NON-REFUNDABLE REGISTRATION FEE 1000/=
- PURCHASE OF INITIAL SHARES @KSH 20 500/=
- Convenience fees 15/=
REQUIRED AMOUNT TOTAL: 1515/=

OPTIONAL DOCUMENTATION:
- CONSTITUTION/BY-LAWS FEES 300/=
- MEMBERSHIP CARD FEES 100/=
- MEMBERSHIP POLICY FEES 100/=
- Convenience fees 15/=
  TOTAL 2015/=
TO VIEW THE TERMS AND CONDITIONS, CLICK ON THE "terms and conditions" BELOW.
Terms and Conditions*
Should be Empty: