AFRICAN ALLIANCE INSURANCE COOPERATIVE
MEMBERSHIP APPLICATION FORM
Applicant's Details
First Name
Last Name
Staff ID
Department
Gender
Email Address
Staff Category
Date Employed
Company
Location
Telephone Number
Home Address
Monthly Savings
Password
Enter Your Password
NEXT OF KIN
Applicant's Next of Kin
Name Of Next of Kin
Relationship With Next of Kin
Address of Next of Kin
Declaration
I hereby confirm that the information provided above is correct
First Name
Last Name
Date of This Application
I
Covenant And Sign
Do Not Covenant And Do Not Sign
This Membership Application Form
MONTHLY DEDUCTIONS FROM PAYROLL FORM
C/O AFRICAN ALLIANCE INSURANCE COOPERATIVE
No 54, Awolowo Road, Ikoyi, Lagos.
AUTHORITY FOR MONTHLY DEDUCTIONS FROM PAYROLL
Date
Staff Number
Company
Department
Location
I
A member of the AFRICAN ALLIANCE INSURANCE COOPERATIVE, having read the bye-laws of the society, hereby authorize the Finance and Account Department, through the payroll unit to make monthly deduction of
from my salary until further notice and the sum paid to AFRICAN ALLIANCE INSURANCE COOPERATIVE, for and on my behalf.
The decision is with effect from the month of
Staff Category
Dated this Day
Date
I
Covenant And Sign
Do Not Covenant And Do Not Sign
This Authority For Monthly Deduction From Payroll Form
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