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MEMBER’S PROCUREMENT APPLICATION FORM |
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SURNAME…………………………………… | OTHER NAMES………………………………....................... | |||||||||||||||
ORACLE NO……………………..…………... | MEMBERSHIP NO …………………………......................... | |||||||||||||||
MDA ADDRESS ………………….……..………............................................................................................................. | ||||||||||||||||
OFFICE/SCHOOL …………………………………………………………………………..………………..................... | ||||||||||||||||
PRODUCT VALUE …………………………..…………………………………………………………..……..………………. | ||||||||||||||||
ACCOUNT BALLANCE ……………………………………………………………………………………..………………… | ||||||||||||||||
NET PAY (attachment of recent payslip) ………….………………………………………………………………………(compulsory) | ||||||||||||||||
NEXT OF KIN ………………………………………………………………………………Relationship ……………................. | ||||||||||||||||
ADDRESS ……………………………………………………………………………….. PHONE No …………………………… | ||||||||||||||||
I ………………………………………………………………..hereby confirmed transaction with the above named society |
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Payment Schedule
CAVEAT EMPTOR PLEASE ALL PAYMENTS MUST BE MADE TO THE SOCIETY’S BANK ACCOUNT I understand that the issuance of a dud/bounce cheque is a crime under the Central Bank Act, and that same is enforceable by the Economic and Financial Crimes Commission (EFCC). I agree to be bound by the decision of the society to proceed against me once any of my cheques bounced or is dishonoured without having to call me more than once. ……………………………………………………… |
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