MEMBERSHIP FORM – Boland Muslim Burial Society

MEMBERSHIP FORM

MEMBERSHIP APPLICATION

Newsletter

BURIAL PLANS

View Terms & Conditions. Fields marked with an asterisk (*) are mandatory.

Join Date (Please ensure the first payment is received by this date)

Select a Burial Plan by clicking on the circle

Standard Plan for younger than 65 at R70 p/m with full benefits from month 7.

Senior Silver Plan for older than 64 at R70 p/m with limited benefits from month 7.

Senior Gold Plan for older than 64 at R140 p/m with full benefits from month 7.

I AGREE TO THE TERMS AND CONDITIONS FOR THE STANDARD PLAN (MEMBERS YOUNGER THAN 65) *

BENEFITS:
The Standard Plan will cover burial costs to the Principal member, his/her spouse and eligible children. Burial costs will be limited to:
1. cost to Municipality for grave
2. cost to Paarl Muslim Jamaa for Kafan and
3. R1,000 cash to the nominated beneficiary

WAITING PERIOD
From date of receipt of the first contribution, a six month waiting period will apply before full cover will come into effect. In the event of death during the waiting period, only contributions during this period will be refunded to the nominated beneficiary.

MONTHLY CONTRIBUTIONS
The monthly contribution is R70 p.m with a double payment of R140 for the first month. Contributions are payable monthly in advance before or on the 7th of each month.
If monthly contributions are three or more months in arrears, membership will lapse and the member will forfeit all his/her contributions and has to reapply to have membership reinstated. If the policy is less than 3 months in arrears at date of claim, the arrears will be deducted from the R1,000 cash payment.

ELIGIBLE CHILD
An unmarried child, 20 years and younger, of the Principal Member, including a stepchild or legally adopted child.
Benefits for the unmarried child will end on the 21^stbirthday or when the child gets married, whichever event occurs first.
Details and ID of eligible children should be supplied to the Society at the time the Principal Member joins the scheme.

A newborn baby will only be covered once the details of the newborn have been provided to the Society.

Full Terms and Conditions

I AGREE TO THE TERMS AND CONDITIONS FOR THE SENIOR SILVER PLAN (MEMBERS OLDER THAN 64) *

BENEFITS:
If death occurs within the following periods, the benefits will be as follow:
1 to 6 months : total contributions will be returned
7 to 12 months : contributions + 25%
13 to 24 months : contributions + 50%
25 to 36 months : contributions + 75%
37 months and more : contributions x 2

Benefits will be limited to the smaller of the above OR burial costs + R1 000 and will, depending on available benefits, be applied in the following manner and order of priority:
1. cost to Municipality for grave, and then
2. cost to Paarl Muslim Jamaa for Kafan and if any funds are available, then
3. R1,000 cash or portion thereof to the nominated beneficiary or closest relative if no beneficiary was nominated.

WAITING PERIOD
From date of receipt of the first contribution, a six month waiting period will apply before full cover will come into effect. In the event of death during the waiting period, only the contributions during this period will be refunded to the nominated beneficiary.

MONTHLY CONTRIBUTIONS
The monthly contribution is R70 p.m with a double payment of R140 for the first month. Contributions are payable monthly in advance before or on the 7th of each month.
If contributions are three or more months in arrears, membership will lapse and the member will forfeit all his/her contributions and has to reapply to have membership reinstated. If the policy is less than 3 months in arrears at date of claim, the arrears will be deducted from the R1,000 cash payment.

Full Terms and Conditions

I AGREE TO THE TERMS AND CONDITIONS FOR THE SENIOR GOLD PLAN (MEMBERS OLDER THAN 64) *

BENEFITS:
The Senior Gold Plan will cover burial costs to the Principal member and his/her spouse. Burial costs will be limited to:
1. cost to Municipality for grave
2. cost to Paarl Muslim Jamaa for Kafan and
3. R1,000 cash to the nominated beneficiary

WAITING PERIOD
From date of receipt of the first contribution, a six month waiting period will apply before full cover will come into effect. In the event of death during the waiting period, only premiums paid during this period will be refunded to the nominated beneficiary.

MONTHLY CONTRIBUTIONS
The monthly contribution is R140 p.m with a double payment of R280 for the first month. Contributions are payable monthly in advance before or on the 7th of each month.
If contributions are three or more months in arrears, membership will lapse and the member will forfeit all his/her contributions and has to reapply to have membership reinstated. If the policy is less than 3 months in arrears at date of claim, the arrears will be deducted from the R1,000 cash payment.

Full Terms and Conditions

MAIN MEMBER'S DETAILS

Full name(s) and surname

ID Number

Contact Number

Email address

Address Line 1

Address Line 2

Area

City / Town

Marital Status

Married

Single

SPOUSE'S DETAILS

A spouse is defined as a Muslim marriage partner. A life partner, boyfriend or girlfriend are not covered.

Spouse full name(s) and surname

ID Number

* Contact Number

I declare I am legally married to the person mentioned above and I understand all benefits may be forfeited if I make a false statement. *

Do you want to add any children younger than 21?

Yes

Select number of children to add (Maximum 5)