MEMBERSHIP APPLICATION

SEGUKU WTM SACCO

Join our savings and credit cooperative and grow financially through saving, investment and affordable financial solutions.

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01. Personal Information

Full Name *

Date of Birth *

Gender

Marital Status

National ID Number *

Company ID Number

Phone Number *

Alternative Phone

Email Address

Job Title

Department

02. Residential Address

District *

Sub County

Parish

Village / LC1

Zone

Taxi Route

Last Taxi Stage

Google Map Link

Home Directions / Landmarks

03. Employment Information

Employer

Contract Ending Date

Bank Account Name

Bank Name

Bank Branch

Account Number

04. Savings Commitment

Monthly Deposit Amount (UGX) *

Entrance Fee (UGX)

Share Capital (UGX)

Preferred Savings Date

Additional Notes

05. Next of Kin Beneficiaries

Person(s) designated to receive SACCO benefits in the event of loss of life.

Beneficiary 1

Full Name *

Relationship

Phone Number

Allocation %

Beneficiary 1 Photo * Maximum size: 2MB

Beneficiary 2 (Optional)

Full Name

Relationship

Phone Number

Allocation %

Beneficiary 2 Photo Maximum size: 2MB

06. Required Documents

Passport Size Photo * Maximum size: 2MB

National ID Front *

National ID Back

07. Salary Deduction Authority

I hereby authorize my employer to deduct my agreed monthly contribution from my salary and remit it to SEGUKU WTM SACCO until this authority is revoked in writing.

Monthly Deduction Amount (UGX)

Effective Date

08. Declaration

I confirm that the information provided in this application is accurate and complete. I agree to comply with the SEGUKU WTM SACCO By-laws, policies and regulations governing the society.

I accept the declaration above.

Digital Signature (Full Name)

Application Date

After submission your application will be reviewed by the SEGUKU WTM SACCO committee.