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info@shirikasacco.co.ke

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SHIRIKA DT SACCO SOCIETY LTD SHIRIKA CO-OP HOUSE P.O. BOX 43429-00100 – NAIROBI

DATE DATE OF APPLICATION: *

APPLICATION FOR MEMBERSHIP AND ADMISSION

WSS
Option 1
ATM card
Option 1
I hereby make application for membership of your Society and agree to abide by the By-laws/or any amendments thereof. *
Option 1

a) EMPLOYMENT PARTICULARS:

NAME: (as per your I/D card) *
DATE OF BIRTH *
ID NUMBER *
CURRENT ADDRESS *
Personal/TSC/Staff No.
EMPLOYER/MINISTRY/SELF *
MOBILE NUMBER *
STATION
DESIGNATION
TERMS OF SERVICE
DATE OF EMPLOYMENT
KRA PIN NO:
EMAIL ADDRESS

b) HOME ADDRESS:-

Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
PARENT/FATHER’S/GURDIAN’S NAME &ADDRESS…

c) NEXT OF KIN AND ADDRESS:

NAME *
I/DNO *
POSTALADDRESS
CELL NO *

d) OTHER PARTICULARS:-

MEMBER HAS BEEN RECRUITEDBY
M/NO
CURRENT SACCO SOCIETY
SHARES/DEPOSIT BALANCEKSH
LOAN BALANCE KSH:
I AUTHORISE YOU TO DEDUCT DEPOSIT OF KSH *10% OF MY TOTAL EARNINGS PER MONTH OR MORE.
KINDLY SHARE A COPY OF YOUR ID, PASSPORT SIZE PHOTO AND SIGNATURE TO OUR EMAIL info@shirikasacco.co.ke
Upload Copy of your signature and your Kenyan ID

FOR OFFICIAL USE ONLY:

DATE OF ADMISSION TO MEMBERSHIP
APPROVED BY MANAGEMENT COMMITTTEE MIN NO
DATE
ENTRANCE FEE KSH: 1000= PAID ON
THE FIRST SHARE PAID IN
MEMBERSHIP NUMBER ASSIGNED (SECRETARY)

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