Application Form

Date

Application Type

New Member

Existing Member Upgrade

Select Plan

No Joining Fee

Plan A (R240pm)

Plan B (R280pm)

Plan C (R380pm)

Section

Principal Member Details

Name *

Surname *

Email *

Phone Number

Extended Member Details

Add dependents age over 66 - 80

Age 66 to 74 R(55 pm)

Age 75 to 80 (R80 pm)

None

Section

Extended Member

Terms & Conditions

6 Month waiting period below age 65, 12 Month waiting period above age 66 and additional amounts apply. 100 KM free radius. Principal member must be 18 to 65 years of age. Our schemes are 9 plus 1, additional amount for extra member. Full Funeral service is offered to Principal member and dependent up to the age of 14 years. Required documents: ID Copies, Birth Certificates copies.

Application Form

Principal Member Details

Extended Member Details

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076 955 3044

078 466 0576

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