Membership form

APPLICATION FOR MEMBERSHIP

Please complete the form online or download it here.

How did you hear about us?

If your choice is NPSWU Official, please provide their contact number:

Surname

First Name(s)

Date of Birth

ID Number

Gender

Name of Employer

Insitution Employed at

Salary/Pay No.

Rank/Designation Level

Home Address

Postal Address

Work Telephone

Home Telephone

Cell Phone

Email Address

STOP ORDER

I hereby authorise my employer to deduct from my salary an amount of R100.00 per month from the first monthly paysheet after receipt of this notice being my subscriptions of NPSWU and to continue such deuctions until firther notice.

DEATH WELFARE BENEFIT

NOTE: Please add your dependents below. These can be your spouse and/or your children under the age of 21

Name(s) & Surname

ID Number or Date of Birth

Relationship

Name(s) & Surname

ID Number or Date of Birth

Relationship

Name(s) & Surname

ID Number or Date of Birth

Relationship

Name(s) & Surname

ID Number or Date of Birth

Relationship

Name(s) & Surname

ID Number or Date of Birth

Relationship

Name(s) & Surname

ID Number or Date of Birth

Relationship

NOMINATED BENEFICIARY

In the event of a member’s death, a nominated beneficiary must be 18 years and older. Please nominate a beneficiary:

Name(s) & Surname

ID Number

Relationship

In the event of the above beneficiary not being traceable, the Executive Committee may appoint the relative or next of keen provided s/he can furnish proof of relationship with the member.

By signing below, I do hereby apply for membership of NPSWU

Signature

Date

Membership form

APPLICATION FOR MEMBERSHIP

STOP ORDER

DEATH WELFARE BENEFIT

NOMINATED BENEFICIARY

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