Apply For Co-operative Registration Co-operative Registration 1APPLICANT INFORMATION2COMPANY INFORMATION3UPLOAD DOCUMENTS4REVIEW UPLOADED DOCUMENTS5REVIEW COMPLETE APPLICATION6SUBMIT APPLICATION Application IDApplicant informationName and surname*E-mail address* Cell number*List up to 4 preferred company namesPlease dont use any symbols (% $ # @ & – “) in the name as this cannot be registered.1. Company name*2. Company name3. Company name4. Company name Company informationPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Number of sharesFinancial year endJanuaryFebruary (recommended)MarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberHow many members your future company will have*0123456789101112131415A Co-operative must have a minimum of 5 MembersMember 1Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 2Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 3Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 4Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 5Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 6Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 7Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 8Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 9Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 10Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 11Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 12Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 13Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 14Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Member 15Name and surname*E-mail address* Contact number*Resident of South Africa Yes No SA ID number*Passport number*No of shares issued to MemberPhysical address* Address Line 1 Address Line 2 City State Zip Code Postal Address* Same As Physical Address Street Address PO Box Private Bag Street Address* Address Line 1 Address Line 2 City State Zip Code PO Box* Number Post Office Province Postal Code Private Bag* Number Post Office Province Postal Code Download Power of Attorney Co-operative Registration – Power of Attorney (8026 downloads ) Do you want to upload documents?* Yes No Documents Upload* Drop files here or Select files Accepted file types: jpg, gif, pdf, doc, docx, xls, xlsx, Max. file size: 2 MB, Max. files: 5. Allowed Formats: jpg, gif, pdf, doc, docx, xls, xlsx Max File Size of Each Document Should be 2MBMax Number of Files Allowed is 5If the Files are too big. Please Email at info@registeryourbusiness.co.zaDocuments Required as Below:1. ID Copies of Members2. Power of Attorney Do you want to review your uploaded documents?* Yes! I want to see my uploaded documents No, I don’t want to see my uploaded documents Click on below link to preview your uploaded documents {Image Format Upload:266} Do you want to review your application?* Yes! I want to review my application No, Its Fine Please Review Your Application As Below {all_fields} Submit ApplicationI confirm all information to be true and correct in all aspects and I agree to the registration terms and conditions. Yes No Co-operative RegistrationPrice R0.00 Payment Method* EFT Credit / Debit Card Banking Details Bank:FNBAccount Name:Register Your BusinessAccount Number:627 1367 7493Branch Code:250 655