MEMBERSHIP APPLICATION FORM

Main Member Details

Names(Required)
Address

Dependents (up to 14)

Names
Names
Names
Names
Names
Names
Names
Names
Names
Names
Names
Names
Names

Signature and Consent .

MM slash DD slash YYYY

Terms and Conditions
R230 PM

1. Membership becomes active upon receipt of the first payment and completion of this form.
2. A waiting period of three (3) months applies for new members before full funeral benefits are claimable.
3. Premiums must be paid monthly in advance. Failure to pay within 30 days may result in suspension or termination of cover
4. All dependents listed must be directly related to the main member (spouse, children, parents, siblings or close relatives.
5. Claims must be submitted within 6 months of the deceased’s date of death, accompanied by all required documentation.
6. Bakgwadiba Financial Services (BFU) reserves the right to update or amend membership terms with prior notice to member
7. No cash refunds will be provided for unused months or early cancellations.
8. Personal information collected will be used solely for administrative and service-related purposes in compliance with POPIA
9. Membership benefits are not transferable between individuals.
10. The company reserves the right to request additional verification documents when necessary.