Member Registration Form

Registration Form

Personal Details
* StaffID:		* Gender:
* First Name:		* Last Name:
Other Name:		* Department:
* Payroll Group:
Year of Birth:		* Email:

Contact Details
* Address:		* City:
* State:		Telephone:

Next of Kin
Full Name:		Kin Address:
City:		State:
Email:		Phone:

Bank Details
* Bank Name:		* Account No:
Bank Branch:		State:

Contributions
* Savings:		Min Savings Amt:	20,000.00