Documents required:

  • Copy of NPO registration certificate
  • ID copy of authorised person who completes the application form (ID Book / ID Card)
  • Proof of NPO address (utility bill no older than 3 months in the name of the NPO)
  • Proof of NPO bank account (bank statement / cancelled cheque / bank letter in the name of the NPO)

The Shoprite Group Act for Change Card Application

Organisational Details

    * Please attach a copy of your NPO Registration Certificate.

    Max size: 5MB
    File type: (jpg, png, pdf)


    Physical Address

    Applicant Contact Details

    Details of Authorised Representative

    I hereby confirm that the information provided is true and correct and that I have the authority to do so.

    I agree to the Terms & Conditions

      * Copy of ID Book / Card

      Max size: 5MB
      File type: (jpg, png, pdf)

        * Utility bill no older than 3 months in the name of the NPO

        Max size: 5MB
        File type: (jpg, png, pdf)


        Bank Account Details

        We require this information to assess the credit status of your organisation:

        Year(s)

          * Bank Statement / cancelled cheque / bank letter in the name of the NPO

          Max size: 5MB
          File type: (jpg, png, pdf)


          Debit Order Authorisation

          I hereby confirm that the information provided is true and correct and that I have the authority to do so.

          I agree to the Terms & Conditions

          Preferences

          e.g. Checkers Hyper - Brackenfell


          Purchase Limit

          *Please Note: Organisations can also apply for cards with a zero credit limit. The cardholder would then be required to load funds into the account prior to transacting.


          Signature

          I hereby confirm that all details supplied above are true and correct. I acknowledge that I have read and understand the Terms and Conditions of this application form and agree on behalf of the Organisation to abide by the rules governing the Shoprite Act for Change Card. I confirm that I am duly authorised to make this application on behalf of the Organisation and that the Organisation has the necessary legal capacity to enter into an agreement with Shoprite Checkers (Pty) Ltd as envisaged.

          Your privacy is important to us. Please do not send us any information we have not requested. See our privacy statement for more.