CPF LS4 Personal Membership Form
  • Welriet Community Non Profit Company (sponsoring CPF LS4) Membership Application

    Please complete all questions.
  • Format: (000) 000-0000.
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  • Contributing to Welriet Community NPC in support of

    Community Police Forum Lyttelton Sector 4

    What is your contribution used for:

    Provide volunteer patrollers with necessary safety equipment;
    Provide volunteer control personnel with communication equipment and office facilities during working hours;
    Maintain, license and from time to time upgrade the Welriet NPC radio network;
    Preparation, printing and distribution of marketing and communication material;
    Funding of meetings and events for the community.

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  • DEBIT ORDER Payment Advice & Bank Detail

    The details of my/our bank account is given as follows:
  • TO: (name of beneficary)

    NAME: Welriet Community NPC 

    TRADING AS: Welriet Community NPC

    REGISTRATION NUMBER: 2003/019718/08

    ABBREVIATED NAME REGISTERED WITH THE BANK: Welriet

    BENEFICIARY'S ADDRESS: Office C102, Elarduspark Shopping Centre, 837 Barnard street, Elardus Park, Pretoria, 0181

  • Mandate to an Agreement with: Welriet Community NPC (Registration Number: 2003/019718/08) (Hereinafter referred to as Welriet) of Office C102, Elarduspark Centre, 837 Barnard Street, Elardus Park, Pretoria, 0181

    1. Abbreviated name as registered with the bank: Welriet.
    2. The reference number of this agreement is: ........................................... (to be completed by Welriet).
    3. I/We undertake to pay the monthly levy as stipulated above. (If EFT is selected, please make it a “recurring payment”.)
    4. I/we hereby authorise Welriet to issue and deliver payment instructions to their Banker for collection against my/our above-mentioned account at my/our above-mentioned Bank (or any other bank or branch to which I/we may transfer my/our account) on condition that the sum of such payment instructions will never exceed my/our obligations as stipulated in the above form and commencing on date stated in the agreement and continuing until this Authority and Mandate is terminated by me/us by giving you notice in writing of not less than 20 ordinary working days, and sent by electronic mail to info@lyttelton4.co.za or delivered to your address as indicated above. The individual payment instructions so authorised must be issued and delivered as mentioned under “DELIVERED AS FOLLOW” above. In the event that the payment day falls on a Sunday, or recognised South African public holiday, the payment day will automatically be the preceding ordinary business day. Furthermore, if there are insufficient funds in my account to meet the obligation, you are entitled to track my account and represent the instruction for payment as soon as sufficient funds are available in my account. I/We understand that the withdrawals hereby authorised will be processed through a computerised system provided by the South African Banks.
    5. I/We acknowledge that all payment instructions issued by you shall be treated by my/our abovementioned Bank as if the instructions have been issued by me/us personally.
    6. Cancellation: I/We agree that although this Mandate may be cancelled by me/us, such cancellation cannot cancel the Agreement between my(our)self for as long as I am resident in the Welriet area of interest, or in the case of a business, as long as the business is situated in the Welriet area of interest. I/We shall not be entitled to any refund of amounts which you have withdrawn while this Mandate was in force, if such amounts were legally owing to you.
    7. I/We undertake to only make use of the 2 way radio and frequency whilst being a paying/ paid-up member of LS4, and agree to LS4 suspending/blocking the use of the 2 way radio frequency and/or device set up for use where abuse or misuse is evident/ suspected and /or where the required monthly levy is not paid.
    8. I/We undertake to pay an additional R50,00, being bank charges levied against Welriet, should I/we make my/our contribution by means of a cash payment at a bank.
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