SAF Membership Form

SAF Membership Form
Welcome to the Seychelles Alzheimer’s Foundation (SAF)

Thank you for supporting our mission to improve the lives of people living with dementia and their families in Seychelles.

Annual Membership Fee: SCR 400

Accepted Payment Methods:

• Cash (payable to the Secretary or Treasurer)
• Online Banking Transfer

Your membership becomes Active only after payment is verified.

Payment Instructions

If paying by Online Banking, please make payment NOW and screenshot your proof of transfer before completing this form:

Please Transfer SCR 400 to the following SAF Account

Bank: Mauritius Commercial Bank (Seychelles) Ltd, Victoria
Account Name: Seychelles Alzheimer’s Foundation
Account Number: 00000894974

For international Transfer
IBAN: SC89MCBL06010000000000894974SCR

SWIFT CODE: MCBLSCSC

Reference: Your Full Name – Membership

You can also pay at our Annual General Meeting

Your Membership is Valid for 1 year.

Receipt will be provided once the transfer has been verified by the Treasurer

Member Details
Full Name*

First NameLast Name
National ID Number (NIN)*
Date of Birth*

DayMonthYear
Date
Mobile Number*
Email*
example@example.com
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Your Membership status
Membership Type*

New MemberRenewal Member

A little bit more about your interests:
How did you hear about us?*
I am interested of becoming a member because:*

I am a relative of a person living with Alzheimer's DementiaI am a ProfessionalI am a carerAny other reasons
What is your relation to the person living with Alzheimer's Dementia*
What is your Profession*
Any other reasons, please specify:

Membership Payments
Payment Method*

Cash / ChequeOnline Banking Transfer
Payment Instructions (CASH/CHEQUE)

If paying by Cash:

You may pay SCR 400 to the SAF Secretary or SAF Treasurer.

A receipt will be issued.

Opening Hours are from Monday to Friday Between 10:00 to 16:00

Excluding public Holidays

You can also pay at our Annual General Meeting

Your Membership is Valid for 1 year.
Payment Instructions (ONLINE BANKING)

If paying by Online Banking:

Please Transfer SCR 400 to the following SAF Account

Bank: Mauritius Commercial Bank (Seychelles) Ltd, Victoria
Account Name: Seychelles Alzheimer’s Foundation
Account Number: 00000894974

For international Transfer
IBAN: SC89MCBL06010000000000894974SCR

SWIFT CODE: MCBLSCSC

Reference: Your Full Name – Membership

You can also pay at our Annual General Meeting

Your Membership is Valid for 1 year.

Receipt will be provided once the transfer has been verified by the Treasurer
Upload Proof of Payment (Online Banking Only)

Cancelof
Secretary email
example@example.com

Consent & Declaration*

I confirm that the information provided is accurate.I consent to SAF storing my information for membership and communication purposes.I understand that my membership becomes Active only after payment verification.
Signature*

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