1. finance
2. bank
3. bank account

Stima Investment Co-operative Society Limited.
P.O Box 75629, 00200 NAIROBI.
Tel: 020 2363843
Mobile: 0713 - 905195/0731 - 298917
Email: [email protected] / [email protected]
APPLICATION FORM FOR NEW MEMBERSHIP
PART "A"
1.
Full name……………………………………………………………………………………………….
2.
Nationality…………………………………… Date of Birth………………………………………….
3.
Staff Number (Energy sector employees)………………. ID/Passport No…………………………….
4.
PIN No.……………………………………….. Address…………...………………………………….
5.
Present location (Country/state/town/depot)…………….………………….……….……………..............
6.
Mobile No……………………………………. Email: ………..……………………………………
7.
Name of Kin/Nominee………………………………………………………………………………

I/D No……………………….…Date of Birth…………….....Relationship …………………………

Tel No……………………………………………Address ………………………………………….
PART "B"
I wish to apply for …………….……shares of Kshs. 200.00 each valued at Kshs………….………………
Mode of payment:
a)
Cash/Bank Cheque/Money order/ Bank Transfer for Kshs……………………………………….
b) Through my salary in ………………… equal installments, with effect from ……………………
c) Others ………………………………………………………………………………………………..
NOTE:
a)
The minimum share application is 300shares at kshs 200/- each totaling to Kshs. 60, 000/-
b) Each new member must register with Kshs 5, 000.00
c)
All payments must be receipted by Stima Investment and an official receipt issued.
d)
I confirm I have read and will abide with the Society By-Laws.
e)
Payment can be done at :
BANK: Co operative Bank, BRANCH: Stima Plaza Branch, Account No: 011 2007 0889 200,
Swift Code: KCOOKENA, Branch Code: 11035
Or
Stima Sacco Fosa Prime Account No: 5-02-09277-00
Or
Mpesa Pay bill number: 832500, Account number is your ID / Passport Number
Member Bank details
1. Bank Name…………………………………………………………………………
2. Bank Branch……………………………………………………………………….
3. Bank Account………………………………………………………………………
4. Name of the Account……………………………………………………………….
Signed………………………………………………….…………Dated………………………….……………………….
NOTE:
1.
You are required to attach a copy of your ID and PIN and a passport size photograph while returning this form to the
office.
2.
This are confidential details and will only be used for the purpose of updating your records only in the office
3.
Note that the details given above will only be change only upon receipt of written instruction by the same member.
Introduced By:Name…………………………………………….S/No:………………………….Depot:……………………………
PART "D"
FOR OFFICIAL USE ONLY
No. of shares applied………………………No. of shares allotted……………………………………..
Date of Purchase……………………. Processing Officer's Signature ………………………..………
Membership number allocated………………………………………………………………………….