Membership

 Application

Membership Application Form

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Name
Date of Birth

(Part two) APPLICATION

I Mr./Mrs./Ms.

do hereby make an application for membership of the co-operative and agree to abide by the By-Laws, Rules and Regulations governing the co-operative and/ or any amendment thereof My monthly savings will be

per month with effect from the date of admission Non Refundable registration fee is Kshs. 500 Minimum savings shall be Kshs.1000 per month.

(part three) NOMINATED NEXT OF KIN

I, the undersigned do hereby instruct and authorize the co-operative to refund the whole amount of my deposits and benefits due to me - less any indebtedness owed to the co-operative by me - to the following Nominee (s):

1st Nominee

Name

2nd Nominee

Name

3rd Nominee

Name

4th Nominee

Name

(Indicate proportions in percentage against each name if deemed necessary).

Full name of the attesting Witness
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