RENEWAL SAVINGS AND CREDIT SOCIETY
PASSPORT PHOTO
P.O BOX 26083, KAMPALA, UGANDA
TEL; 0773758073, 0704504007
Application form
Title
Mr
Miss
Mrs
Surname: …..Jonathan …………
First name: ……Mukiibi….. Rollin
Work place...Africa Renewal University ..
Profession: ......IT Manager........
Personal details
Phone contact: …..0702961004……..
Marital status
Married
Email: Joookat@gmail.com
Single
Residence:...Gaba Mission……
Divorced
LC1.....Gaba mission……..
Next of kin: ……. Male Moses ...
Your relationship…… My in-law ….. (Muko)
Phone contact.....0772976868..........
email:
mosesmfca@gmail.com
I hereby apply to be a member of Renewal Savings and Credit Society. And l commit myself
to save shillings.180,000/= per month from the month of .....March....2022..........
Deduct from
Other Incomes
Salary
I authorise my employer to deduct this from my monthly salary.
Date:..22/2/2022.....
signature:..
Who recommended this SACCO for you?
1……MARIAH ……..
2…SLYVIA ………………
For Official Use Only
Advised
Accepted
Rejected
Officer in charge Name................................................................signature.............................date.............
Note each form is only shs10, 000/= non refundable
Minimum Deposit 30,000/=share capital 24,000/=