Package:
Premium:
R
p/m
Waiting Period:
months
Cover Amount Payout:
R
DICHABA GROUPS FUNERAL and BURIAL SOCIETY
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Step 1: Personal Information
Title
Choose Title
Mr
Mrs
Miss
Ms
Dr
Prof
Hon
Rev
Not Specified
First Name
Second Name (optional)
Last Name
Date of Birth
ID Number
Cell No
Email
Income Day
Source of income
Select Source of Income
Salary
Self-Employed
Investments
Pension
Business Ownership
Rental Income
Freelance Work
Government Assistance
Child Support
Alimony
Disability Benefits
Student Loans
Other
Next
Step 2: Address Information
Address Street
Address City
Zip Code
Branch you'd like to be served on
Choose Branch
Bolobedu South
GIYANI
LENYENYE/MAAKE
MAMITWA
MAWA VILLAGES
MOKWAKWAILA
MOKWATHI VILLAGE
MOOKGO BLOCK 5,6,7
NKOWANKOWA
POLOKWANE
RAMOTSHINYADI (makoti complex)
RAMOTSHINYADI (MAKOTI)
RUNNYMEDE
SEKGOPO
SEKORORO
TEMBISA
TZANEEN
WALLY VILLAGE (OOGHOEK CLINIC)
XIHOKO
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Step 3: Select packages
Plans
Select plan
Dichaba Groups
Extended family members
Family Funeral Cover (18 to 60YRS)
Pensioners Family Cover (60 t0 90YRS)
Package
Select Package
details
Add Package
select
Details
#
Package
Max Members
Age
Dependents
Premium
Action
Total: R
0.00
p/m
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