Application For Membership & Share Purchase

I hereby make application for membership and share and agree to conform to the society's by-law and any amendment thereof:

Personal Information

Full Name

ID/Registration No

Account Number

Date of Birth/Registration

Postal Address

Post Code

PIN Number

Mobile No.

Tel - Home

Tel - Office

Email Address

Fax No.

Village

Sub-Location

Location

Entrance Fees:

Individual (KShs.)

Company (KShs.)

Shares Details:

Shares Applied For (No.)

Price Per Share (KShs.)

Cash Purchase (KShs.)

Bankers Cheque (No.)

Cheque Amount

NB: Personal Cheques Not Accepted

Nomination of Next of Kin:

In the event of my death whilst I am a shareholder of K-UNITY SAVINGS AND CREDIT CO-OPERATIVE SOCIETY LTD. I do hereby instruct the SACCO to pay MY NOMINEE here under ALL THE AMOUNTS due TO ME LESS any DEBTS due to the SACCO.

Nominee Full Name

Nominee ID

Nominee Relationship

Nominee Postal Address

Phone No. (Primary)

Phone No. (Other)

Declaration:

I Understand that I am liberty at time to CHANGE the above personal information or any nominee by completing another form which automatically renders THIS form canceled.
I declare all the information given above as TRUE and ACCURATE to the best of my knowledge.
By sending a request, you agree to the processing of your personal data in accordance with the Privacy Policy

I agree to the declarations above