New Member Applictaion Form:

Area Area Rangeview Upper Rangeview Lower Noordheuwel Noordkruin Kenmare x4

ID Number

Surname

First name

Street Name

House Number

Cell

Phone Home

E-mail

Security Company

Occupation

Secondary Member 1:

Name & Surname (Spouse/Partner, Children, Tenant)

Cell No (Spouse/Partner, Children, Tenant)

E-mail (Spouse/Partner, Children, Tenant)

Secondary Member 2:

Name & Surname (Spouse/Partner, Children, Tenant)

Cell No (Spouse/Partner, Children, Tenant)

E-mail (Spouse/Partner, Children, Tenant)

Secondary Member 3:

Name & Surname (Spouse/Partner, Children, Tenant)

Cell No (Spouse/Partner, Children, Tenant)

E-mail (Spouse/Partner, Children, Tenant)

Initial compulsory once off joining fee: R100 (included is a house plaque to identify contributing members) Initial compulsory once off joining fee: R100 (included is a house plaque to identify contributing members) Household Membership fee: R50 per month (pay annually and save R150) Household Membership fee: R 450 per year (Payable every April in advance. Pro-Rata payments are calculated for members who join mid-year)

Kenwood Radio Kenwood Radio Kenwood Radio (R 5500.00 each)

No. of Radios (Prices of radios are linked to the exchange rate; Confirm the price at time of ordering.)

I would like to assist with the following (please mark appropriate box(s)) I would like to assist with the following (please mark appropriate box(s)) Vehicle Patrols Marketing Legal Assistance Communication Administration Victim support Sponsorship Other

Comments / Other:

Identification Card (mandatory): R 50.00 * (Y/N)

No. of Cards

Summer reflective vests: R 180.00 * (Y/N)

No. of Vests

Winter reflective or Dry-Mag jacket: R 450.00 * (Y/N)

No. of Jackets

Vehicle magnetic signs: R 160.00 per board * (Y/N)

No. of Boards

CPF Caps/Beanies: R 70.00 each * (Y/N)

No. of Caps/Beanies

My World ID

Applicant Signature (Name and Surname) SaveClear

Date of Application

Acknowledgement Acknowledgement By signing this application form I acknowledge that I reside in Sector 7 and that I am a non-contributing member of the Sector 7 CPF. By signing the application form I agree to make monthly/yearly membership contributions towards RNK Community Watch for value added services and should I seize to make contributions I will remove my house plaque from being displayed and authorize the CPF patrollers to remove my house plaque on my behalf. I herewith authorise the Sector 7 CPF patrollers to enter my property to conduct a lawful search and/or to arrest any suspect on my property. All information will be treated with confidentiality. I acknowledge that I’m under no obligation to give any information I do not wish to provide. I hereby waive any action held against the RNK Community Watch, RNK Sector 7 Watch and Sector 7 Community Police Forum arising from participation in the Community Watch and Forum activities, and have read and understand the RNK Community Watch as well as Sector 7 CPF CONSTITUTIONS and General Standard Operating Protocols. Do Not send me sms’s