Registration – Friends of Vision Welfare

info@friendsofvision.com

Dosani House, Glyn Jones Rd, Blantyre.

+265 999 036 082

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PART A: MEMBER'S PERSONAL INFORMATION

Membership

Renewal
New Member

Name

First

Last

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Date of Birth

District of Origin

Maritual Status

Identification

Source of Income

Employment
Business

Identification Number

Phone Number

NEXT OF KIN DETAILS

Name

First

Last

Relation to the member

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Phone

PART B: MEMBER'S DEPENDANTS

Dependents to be filled in the table below are those of member’s NUCLEAR FAMILY. (Parents, spouses and children) as stipulated in the FOV Welfare Constitution.

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1. Name

Date of Birth

Relationship

ID Number

2. Name

Date of Birth

Relationship

ID Number

3. Name

Date of Birth

Relationship

ID Number

4. Name

Date of Birth

Relationship

ID Number

5. Name

Date of Birth

Relationship

ID Number

Payment

PART C: MEMBER'S DECLARATION

Submission Date

Terms and Conditions

I declare to abide by the rules and regulations of membership of Friends of Vision Welfare.

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