Unity Sacco

MEMBERSHIP APPLICATION FORM

Member Number

A: PERSONAL DATA

Surname

Gender

First Name(s)

E-mail address

Date of Birth

Mobile Number

Nationality

National ID No

County

Sub - County

Residential address: Mr./Mrs./Miss/Prof./Rev./Dr.

B: EMPLOYMENT / BUSINESS DATA

Employment Type

Employer Name

Location

Postal Address

Telephone Number

Occupation

Business Name

Business Location

Postal Address

Telephone Number

Type of Business

C: EMPLOYMENT / BUSINESS DATA

I the undersigned, upon my demise whilst a member of the Sacco, hereby instruct the Sacco 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.

NO.	NOMINATED NEXT OF KIN(S)	RELATIONSHIP	ID/PP NO. If Minor indicate C/o	PHONE NO.	DATE OF BIRTH (D.O.B)	Percentage (%) Assigned
1
2
3
4

D: REMMITANCES

Membership Registration/ Entrance Fee:

1. Individual - Ksh 1,000

2. Group - Ksh 3,000

3. Corporate - Ksh 5,000

Minimum Monthly Deposits Remittance:

1. Individual - Ksh 1,000

2. Group - Ksh 5,000

3. Corporate - Ksh 10,000

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