Application Form - Bonuscard

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How it works
National Suppliers
Suppliers Guide
Benefits
Refer a friend
Enquire now
Do I Qualify
Apply Online
Download Documents

How it works
National Suppliers
Suppliers Guide
Benefits
Refer a friend
Enquire Now
Do I Qualify
Apply Now
Download Documents
Log in

×

How it works
National Suppliers
Suppliers Guide
Benefits
Refer a friend
Enquire Now
Do I Qualify
Apply Now
Download Documents
Log in

Become a member today!

Apply online right now and start earning.

Financing

Finance your next car through Pretorium Trust

Where to shop

Use your card and earn bonus on your purchases.

Start earning bonus on you Insurance premiums.

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APPLICATION FOR MEMBERSHIP

PERSONAL INFORMATION

All fields required.

Title *

Names in Full *

Surname *

Identification Number *Please enter a valid 13-digits South African ID number0 / 13

Email *

Please upload ID Document

Drag and Drop (or) Choose Files

Please upload Proof of Residence

Drag and Drop (or) Choose Files

Mobile *

Alternative Phone

Street Address *

PO Box

Suburb *

Suburb

City *

City

Province *

Province

Postal Code *

Postal Code

Do you own fixed property? *

If not, current living arrangements?

Years at present address *

Language *Select Language

RSA Resident *

Maritial Status *

Number of Dependents *

Were you previously a member of Pretorium Trust?YesNo

If 'Yes' Membership Number

EMPLOYMENT DETAILS

All fields required.

Type of Employment *

Name of Employer *

Years of Service *

Occupation *

Employer Physical Address *(Current Employer)

Name of previous employer and years of service

SPOUSE'S PERSONAL INFORMATION

Required if married in community of property

Spouse's Initials

Spouse's Maiden SurnameIf applicable

Spouse's Identification numberPlease insert a valid 13-digit South African ID number (If applicable)0 / 13

Spouse's Phone

Please attach Spouse's ID document

Drag and Drop (or) Choose Files

If applicable

Spouse's Employment Details

Type of Employment

Name of Employer

Occupation

Employment Date

Employer Physical Address(Current Employer)

FRIEND OR RELATIVE INFORMATION

(not living with you)

First and Last Name *

Relationship *

Mobile *

Home Phone

Residential Address

AUTHORISED CARD HOLDERS

MEMBER - Title and Initials

Surname

ID NumberPlease insert a valid 13-digit South African ID number0 / 13

Card Limit

ZAR

SPOUSE - Title and Initials

Surname

ID Number0 / 13

Card Limit

ZAR

CHILD - Title and Initials

Surname

ID Number0 / 13

Card Limit

ZAR

Total monthly purchase limit applied for

ZAR

Do you require a budget facility? *YesNoNO BUDGET PURCHASES ALLOWED ON LIQUOR, FOOD OR PETROL. No purchase of less than R300 will qualify for the budget facility. PURCHASES ON BUDGET QUALIFY FOR THE ANNUAL BONUS

Budget limit applied for *

ZAR

Date *

Applicant's Signature *

Start signing your signature here

I/We consent to the Credit Provider verifying my/our credit record/s with any credit reference agency or other Credit Providers and verify all information supplied on this application.

Spouse Signature

Start signing your signature here

If applying for Pretorium Trust card.

AFFORDABILITY ASSESSMENT

All fields required.

Monthly Income

Gross Salary - Applicant

ZAR

Gross Salary - Spouse

ZAR

Other Income - Applicant

ZAR

Other Income - Spouse

ZAR

Please specify

Please specify

Total Income - Applicant

Total Income - Spouse

Please upload Proof of Income (Applicant)

Drag and Drop (or) Choose Files

Please attach 3 months latest payslips or bank statements

Please upload Proof of Income (Spouse)

Drag and Drop (or) Choose Files

Please attach 3 months latest payslips or bank statements

Payslip Deductions

Medical Aid - Applicant

ZAR

Medical Aid - Spouse

ZAR

Pension / Provident Fund - Applicant

ZAR

Pension / Provident Fund - Spouse

ZAR

PAYE - Applicant

ZAR

PAYE - Spouse

ZAR

UIF - Applicant

ZAR

UIF - Spouse

ZAR

Other Deductions - Applicant

ZAR

Other Deductions - Spouse

ZAR

Total Deductions - Applicant

Total Deductions - Spouse

Net Salary - Application

Net Salary - Spouse

Monthly Expenses

Accommodation Expense - Applicant

ZAR

Accommodation Expense - Spouse

ZAR

Transport Expense - Applicant

ZAR

Transport Expense - Spouse

ZAR

Food Expense - Applicant

ZAR

Food Expense - Spouse

ZAR

Education Expense - Applicant

ZAR

Education Expense - Spouse

ZAR

Medical Expense - Applicant

ZAR

Medical Expense - Spouse

ZAR

Maintenance Expense - Applicant

ZAR

Maintenance Expense - Spouse

ZAR

Water & Electricity - Applicant

ZAR

Water & Electricity - Spouse

ZAR

Other Expenses - Applicant

ZAR

Other Expense - Spouse

ZAR

Total Expenses - Applicant

Total Expenses - Spouse

Accounts

Asset Finance - Applicant

ZAR

Asset Finance - Spouse

ZAR

Personal Loans - Applicant

ZAR

Personal Loans - Spouse

ZAR

Credit Cards - Applicant

ZAR

Credit Cards - Spouse

ZAR

Bond Repayments - Applicant

ZAR

Bond Repayments - Spouse

ZAR

Cellphone Expense - Applicant

ZAR

Cellphone Expense - Spouse

ZAR

Micro Loans - Applicant

ZAR

Micro Loans - Spouse

ZAR

Security - Applicant

ZAR

Security - Spouse

ZAR

Insurance - Applicant

ZAR

Insurance - Spouse

ZAR

Clothing - Applicant

ZAR

Clothing - Spouse

ZAR

General Retail - Applicant

ZAR

General Retail - Spouse

ZAR

Total Accounts - Applicant

Total Accounts - Spouse

Min Bond Repayment - Applicant

ZAR

Min Bond Repayment - Spouse

ZAR

Disposable Income

Pretorium Trust Card

Disposable Income Total - Applicant

Disposable Income Total - Spouse

STATEMENT OF ASSETS

Fixed Property

Suburb

Market Value

ZAR

Current Balance

ZAR

Suburb

Market Value

ZAR

Current Balance

ZAR

Suburb

Market Value

ZAR

Current Balance

ZAR

Movable Assets

Description

Market Value

ZAR

Description

Market Value

ZAR

Description

Market Value

ZAR

CREDIT AND PAYMENT HISTORY

Under Administration or Debt Review? *YesNoIn the past 3 months, have you applied for debt review or debt counseling or are presently under administration or debt review

Any disputes in process with a Credit Bureau? *YesNo

Lost Card Protection (optional) *Yes (R12)NoThe member confirms that he is aware of the Card Protection Fund offered by Pretorium Trust and that he must apply in writing for protection under the scheme. In terms of Pretorium Trust's Protection Fund Scheme, the member accepts liability for all payments made by Pretorium Trust or which Pretorium Trust is bound to make in respect of, or arising from, any use of the card before Pretorium Trust is reasonably able to act after receipt of the written notification by the member that the card is lost or stolen. Please debit my Pretorium Trust account annually with (R12 per card) in respect of the purchase cards issued on my membership number and include my name on the list of members of the Purchase Card Safeguarding Fund.

Advance Payment Fund *AgreeThe member must contribute to the Advance Payment Fund at a minimum of R25 per month to a maximum of twice the monthly purchase limit. Please debit my account monthly with R25.

Other Contribution Value

Signature *

Start signing your signature here

Signature Spouse *

Start signing your signature here

CONSENT AND SUBMISSION

Do you wish to receive your statement via: *EmailPost

Would you like to be considered for an automatic annual credit limit increase? *YesNo

Do you choose to be excluded from telemarketing campaigns by or on behalf of the Credit Provider? *YesNo

Would you like to be considered for any mass distributions of e-mails or sms messages conducted by the Credit Provider? *YesNoPromotions by the Credit Provider on behalf of our suppliers

Where did you hear about us?

If referred, Member number?

Preferred Payment Method?

Debit Order Instruction

(If applicable)

Account Holder Name

Account Number

Account Type

Bank Name

Branch Number

Date of Debit Order

Please upload Account Confirmation

Drag and Drop (or) Choose Files

Signed at *

Date *

Date application completed

Signature of Account Holder *

Start signing your signature here

Debit Order approval.

Cost of Credit *

I agree with the membership fees as per the Cost of Credit

Terms and Conditions *

Yes, I agree with the privacy policy and terms and conditions.

Applicant's Signature *

Start signing your signature here

Spouse Signature

Start signing your signature here

If applicable

Save as Draft (THIS DOES NOT SUBMIT THE FORM)

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Pretorium Trust (Co-operative) Limited is an Authorized Financial Services Provider (License No. 2753) and Registered Credit Provider (NCRCP 228).

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