Registration/Update

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Member Update/Application Form

NCSL Application Form (Member)

NCSL Member Number (if existing)

Branch

Request Type

Accounts

New Membership Member Data Update

Channel

MyNCSL Member Online Mobile USSD Service Poro Card

Additional Account (s)

Long Service Leave Housing Scheme

Member Personal Details

Name

Date

Gender

Marital Status

Residential/Postal Address

Mobile (Personal)

Email

Address

Employment Details

(Not applicable for EDA SUPA Members)

Company Name

Pay Officer / HR Email

Occupation

Office Phone

Address

Nomination of Beneficiaries

Full Name

Customer Number

Relationship

Percentage of 100%

Full Name

Customer Number

Relationship

Percentage of 100%

Poro Account Deposit

I authorize NCSL to debit my General Savings Account with an amount of K10.00 and credit my Poro Account.

I authorize the deduction of () from my salary, to be paid fortnightly/monthly to the NCSL on my behalf.

Identification

Please attach a clear copy of your valid ID Card when submitting your application form, ncsl shall verify and keep the copy on file. (at least 1 ID copy attached)

Type of ID provided 1:

Type of ID provided 2:

Max. file size: 64 MB.

Reference ID

Channels

MyNCSL Member Online New

New Amendment Cancellation

Consent

I agree that my account can be accessed on the Self-service channel. (Member to authorise on declaration)

Exisiting Number

New Number

Exisiting Email

New Email

Mobile USSD Services

New Amendment Cancellation

Consent

I agree that my account can be accessed through mobile banking

Exisiting Number

New Number

Poro Card

Request Type

New Amendment Cancellation

Preferred Branch for Card Collection

This section is to be completed for replacement and cancellation

Poro Debit Card

Card/Pin Pin

Card Number

Date Card was Lost/Stolen

Maintenance Types

Lost Stolen Locked Other (if other, please specify)

Reason for Maintenance

Salary Deduction Authorization

(Note: Not applicable for EDA SUPA members)

General Savings

Education Savings

Christmas Savings

Poro Account

Please note that it is mandatory for every NCSL member to have a Poro Account and be issued a Poro Card. The minimum contribution to your Poro Account is K10.00 upon first time registration.

Additional Account

(Note: Applicable for required members only)

Long Service Leave

Housing Scheme (MMJV Employees)

Consent

I agree to the privacy policy.

Consent

I agree to the privacy policy.

Net Value PGK

Declaration

I hereby apply to become a member of NCSL. I agree to pay all charges levied by the Rules of the Society and by any amendments thereof registered in accordance with the Savings & Loan Societies (Revised Act 2015). I agree to contribute no less than K20.00 per payment to NCSL. I certify that the information provided on this form is true and accurate. I accept NCSL’s Terms & Conditions which apply to my account(s) and transactions that I conduct on my account(s)

Upload Signature Here

Name

Date

Note: After completing this form send it two (2) weeks before the beginning of the deduction period to: