Online Application
  • Last Name
  • Home Address
  • SurnameFirst NamesID NumberDate of BirthRelationship 
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    Max Age 25 years (Proof of student needed)
  • Bank NameBranchAccount HolderAccount Number 
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  • I hereby authorise Tshianeo to commence a debit order withdrawal from my account on the specified date of the month. if for any reason it is not honoured, two withdrawal runs will be done the next month.
    In the event of this second run being dishonoured, the policy will colapse. I understand it is required that this signed document reaches Tshianeo offices 10 days working days prior to the selected deduction date, if not, the deduction will only qualify for the following calendar month's deduction.
  • This field is for validation purposes and should be left unchanged.