Membership registration

Telkom Employee Membership Form

Complete the details below to apply for SACU membership and set up your monthly debit order.

Telkom Employees Only

Member details · Bank debit order information · Mandate and consent

1. Membership and personal details

I authorise the monthly deduction of my SACU membership subscription from my nominated account, beginning on the date entered below, and continuing until I provide written notice in accordance with the applicable membership terms. Please confirm the current subscription amount with SACU before submitting.

Title *

Full names *

Surname *

South African ID number *

Work telephone

Mobile number *

Requested deduction start date *

Work email

Personal email

2. Bank debit order information

Account holder *

Bank name *

Branch name or code *

Account number *

Debit order date / day *

Account type *

Transmission / Current

Savings

Cheque

3. Debit order mandate and declaration Click to read

I authorise the relevant service provider acting on behalf of SACU to submit the agreed monthly membership contribution debit instruction to the bank account specified above.

If there are insufficient funds to meet the obligation, the payment instruction may be re-presented when permitted by the applicable banking rules. I agree to pay any charges related to unpaid or returned items where applicable.
I acknowledge that payment instructions issued under this mandate will be treated by my bank in accordance with the mandate and the bank's applicable terms.
I understand that cancelling this debit order authority does not automatically cancel my SACU membership or any separate membership agreement. Any amounts legally owing remain payable.
I authorise the monthly deduction of my SACU membership contribution by the authorised payment service provider using its payment processing system.
This authority may only be ceded or assigned where permitted by the underlying agreement and applicable law.

I have read and agree to the mandate and declaration above. I confirm that I am authorised to use the nominated bank account. *

Account holder's full name (electronic signature) *

Date signed *

Privacy reminder: this form requests identity and banking information. Use only a secure connection when handling completed forms. This page is a front-end form template; submission to SACU is not enabled until a secure, approved backend and privacy notice are configured.