TRANS-ELITE COUNTY SAVINGS AND CREDIT CO-OPERATIVE SOCIETY LTD Eldoret—Kisumu Highway, Next to Kapsabet Police Station Opp. Kapsabet District Hospital. P.O. Box 547—30300 KAPSABET KENYA Tel: +254 5352103 Email: info@tecsacco.co.ke SAVE REGULARY, BORROW WISELY & REPAY PROMPTLY MEMBERSHIP APPLICATION FORM I hereby make voluntary application for membership in the society and agree to conform to the By-Laws and any amendment thereof and will pay monthly contribution fee as stated below. Monthly Contribution (Ksh) ___________ Please attach a copy of your ID card PERSONAL DETAILS Name __________________________________________________ D.O.B ___________________________ ID NO: _______________Personal/ TSC No: ___________________ Mobile No: _______________________ Gender Male Female Marital status Single Married Email Address ____________________________________ Address: __________________________ City/Town: _______________________________________ County: ___________________________ Constituency: _____________________________________ Location: __________________________ Sub-Location: _____________________________________ Village: ___________________________ Chief: ___________________________________________ Sub-Chief: ________________________ EMPLOYMENT DETAILS Employment Terms Permanent Temporary Designation :__________________________________ Employer: __________________________________________ Station: __________________________ Phone No: __________________________________________ Address: _________________________ City/Town: _________________________________________ BANK DETAILS Bank: _____________________________________________ Branch: ___________________________ A/C Name: ________________________________________ A/C No: ___________________________ WITNESS Name: __________________________________ M/No: _________________ P/TSC No. ___________________ Sign: ___________________________________ Date: ______________________________ IMPORTANT: Please fill the Nominee Form to nominate your next of kin and submit it together with this application form. OFFICIAL USE ONLY Membership No: ______________________Date: ________________ Admission Date ___________ ________ Committee Signature _______________________________________ DATA OFFICE Computation By: ____________________________ First Deduction in the month of: ______________________ Date: _____________________________________ Signature : ________________________________________
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