Boresha SACCO – Membership Application

Individual Membership Application Form

Welcome to Boresha SACCO Society Ltd. Please fill this form carefully in CAPITAL LETTERS and attach the required documents. Use the Next / Back buttons to navigate between sections.

Documents to attach before submitting:

Applicant's ID card (both sides) OR Passport (bio-data page only)
Copy of KRA PIN certificate
Passport-size Photo (colour)

Application Type

Are you Registering or Renewing your membership?

New Registration Renewal / Re-joining

Document Type

Select the document you are attaching for identification

National ID Card Passport

Application Date

1. Personal Details

Full Name (as per ID/Passport)

Nationality

Gender

Date of Birth

Marital Status

ID Number

ID Serial No.

Maisha No. (Huduma Namba)

County

Sub-County

Ward / Village

Postal Address

Postal Code

Town

Phone No.

KRA PIN No.

E-Mail Address

Any Disability?

No Yes – attach tax exemption certificate

3. FOSA Products and Services

I) FOSA Savings Account (Mandatory)
I wish to open an account with Boresha SACCO. I undertake to comply and be bound by the terms and conditions laid down by the SACCO on its FOSA operations.

II) M-Boresha Mobile Banking

M-Boresha Registration

Authorize – register my FOSA account for Mobile Banking Not Authorize

Safaricom / M-Pesa Registered Number

Boresha SACCO reserves the right to decline mobile banking without giving reasons to the extent permitted by law.

III) SMS Alert Services

I authorize Boresha SACCO to enroll me for SMS alert services and accept the terms of use.

Declaration: I accept to be bound by the terms and conditions of use (as may be amended from time to time). I agree to be liable for any charges incurred and hereby indemnify Boresha SACCO against all losses arising from my use of these services.

4. Contact Person (to be contacted in case of an emergency)

#	Full Names	ID Number	Email	Relationship	Phone Number
1

5. Members Welfare Fund (MWF) – Bereavement Benefits

Declare next of kin to be covered by the Fund (Spouse, Child, Biological Father, Biological Mother).

NOTE: Every member is required to fill a Next of Kin/Beneficiaries Card.

#	Full Name	Relationship
1

Bereaved members are entitled to benefits as per Membership Policy.

Document Uploads

ID Card – Front Side

JPG, PNG or PDF · Max 5 MB

ID Card – Back Side

JPG, PNG or PDF · Max 5 MB

Passport-size Photo (Colour)

JPG or PNG · Max 5 MB · Colour photo only

KRA PIN Certificate

JPG, PNG or PDF · Max 5 MB

7. Declaration

Full Name

ID / Passport Number

Date

I confirm that the information given above is true and correct to the best of my knowledge. By submitting this form, I request to be a member of Boresha SACCO Society Ltd. I agree to abide by the by-laws and membership policy. I have read and agreed to abide by the terms and conditions for this application. I agree that this account shall be operated solely at the discretion of the society and indemnify the society at my cost against any cost incurred or claims arising out of the account.

Applicant Signature

Draw your signature above using your mouse or finger

9. Terms and Conditions

Membership

Pay Membership entrance fee or Renewal of Ksh 1,000.
Meet all membership qualifications i.e. share capital and equity shares contributions as per the policy and bylaws.
Accessing all legitimate information of the Sacco subject to the SACCO's policies and regulations in force.
Attend and actively participate in members meetings and voting where each member has one vote irrespective of his/her shareholding.
Refrain from engaging in any business in competition with the SACCO.
Protect the image of the society and avoid unnecessary incitement or careless talk that can injure the SACCO's reputation.
Inform the SACCO of any change of address or contact whenever it occurs.
Pay all debts due to the SACCO without fail including due capital and equity shares as prescribed per policy.
Comply with the By-laws, the Co-operative Act, the Sacco Rules, Regulations and resolutions of ADM.
Allow the SACCO to collect, process and store my personal information as per the data protection guideline.
Abide by all SACCO terms and conditions stated above as an active member.

Account Opening

Pay account opening fees which shall be the minimum account balance.
Duly filled form with all requisite supporting documents attached (e.g. Next of Kin Nominee form).
Upon submission of the duly completed form, a FOSA account number shall be issued.
Any discrepancy in the statement of account must be reported in writing to the CEO within 14 days of receiving the statement.
The SACCO shall determine from time to time the rate of interest payable on the account subject to prevailing market rates.

FOSA / Mobile Banking / SMS Services

I accept to be bound by the terms and conditions of use (as may be amended from time to time).
I agree to be liable for any charges incurred through the use of these services.
I hereby indemnify Boresha SACCO against all losses arising from my use of these facilities.

I have read, understood, and I agree to abide by all the Terms and Conditions, By-laws and Membership Policy of Boresha SACCO Society Ltd. *

You will receive a reference number upon successful submission.