Membership Application

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PERSONAL DETAILS

Address
Do you belong to a similar Sacco
Were you once a members of Charismata Sacco?

NEXT OF KIN DETAILS

I, the undersigned, in the event of my death whilst a member of the society, hereby instruct the society to pay all amounts due to me less any debts to the society to the person named in this section. I understand that I may alter the name of the nominated next of kin by filling in a subsequent nominated next of kin form.
Address

PAYMENT DETAILS

CO-OPERATIVE BANK ACCOUNT NO: 01120091620300 CO-OP HSE BRANCH MPESA: PAYBILL, BUSINESS NO: 543100 A/C NO (Membership number and branch)
N/B: Registration fee is non-refundable
Application confirmation
To accept this document, please click YES.