SAPU Membership Application Form A

Personal Details
ID Number*
Date Of Birth*

YearMonthDay
Date
First Name*
Surname*
Initials
Title*
Gender*
Marital Status*
Language:*
Personal Contact Details
Phone Number

Area CodePhone Number
Cell Phone Number*
Full Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employers address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Employee Number*
Rank Held*
Station/unit*
Region*
Province*
Office Number*

Area CodePhone Number
Fax Number

Area CodePhone Number
Stop Order
Employee Number*
Surname & Initials*
Cancellation Of Other Union
I {urname33}Hereby cancel my stop order deduction for other Union
Other Unions
Acceptance of T&C
I, the undersigned, hereby apply for membership of the South African Policing Union and undertake to uphold the provisions of the unionas set out in the constitution.
I Request and authorise the Employer's account Officer to deduct R100.00 monthly as membership fee from my salary as from date of this application. The Monthly deductions must continue until such time I cancel it in writing with the South African Policing Union (SAPU) by providing them with a copy of my cancellation form
Full Force Signature with PERSAL number and Rank*
Date

YearMonthDay
DateHourMinutes
For Office Use
Recruiters Name

First NameLast Name
Persal Number
Contact Number
Should be Empty:

For Office Use