Home » Apply Now – Membership Application Personal Details Personal Details Civil Status SingleMarriedDivorcedWidowed Title Prof.DrMrMrsMiss First Name* Middle Name Surname* Date of Birth* Nationality* Place of Birth Marital Status SingleMarriedDivorcedWidowed Number of Dependents Member of any SACCO YesNo Address* Email* Work Telephone Home Telephone Mobile Number (1)* Mobile Number (2) Next of Kin/Spouse Name* Next of Kin/Spouse Date of Birth* Employment Details Employment Details Employer* Department* Unit* Address* Telephone Number* Fax Number Designation* Employee Number* Authorization to Deduct from Salary Authorization to Deduct from Salary I authorize the verification of the information provided on this form as to my credit and employment. I have received a copy of this application. I being a member of the Dithseng SACCOs authorize you deduct funds amounting to of my salary to cover my membership subscription on monthly basis. This authorization takes effect from —Please choose an option—JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember (month) and shall continue in force until cancelled in writing with 3 (three) clear month's notice. Document Uploads Document Uploads Membership Form* KYC Form* ID (Passport/Driving License)* Confirmation of Employment* Applicant's Signature* Date*
