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: [email protected]
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 : ________________________________________