SAPU Membership Application Form A

Personal Details
ID Number
Date Of Birth

YearMonthDay
4 digit year, 2 digit month, 2 digit dayDate
First Name
Surname
Initials
Title
Gender
Marital Status
Language:
Personal Contact Details
Phone Number

Area CodePhone Number
Cell Phone Number
Format: (000) 000-0000.
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
4 digit year, 2 digit month, 2 digit dayDateHourMinutes
For Office Use
Recruiters Name

First NameLast Name
Persal Number
Contact Number
Format: (000) 000-0000.
Should be Empty:

Personal Details

Personal Contact Details

Stop Order

Cancellation Of Other Union

Acceptance of T&C

For Office Use