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MEMBER APPLICATION
Employee Number :
I, , an employee of Chevron Nigeria Limited, hereby apply for membership of the Delta Area Chevron Employees Multi-Purpose Co-operative Society Limited. I have paid the sum of to the DACEMPCS Manager in ackknowledgement of which receipt number dated was issued.

  Please debit my regular savings account with DACEMPCS for the non-refundable registration fee

(Minimum Share capital for every member is Two Hundred Thousand Naira i.e. One Hundred Thousand shares sold at Two Naira per share).

Dated this day of ,

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