Membership Application

Please complete the form below.

Step 1 — Download & Print the Required Forms

Download, print and complete the forms indicated for your employment sector. You will upload scanned copies in Step 2.

Private employees: complete the Direct Debit Form and the Funeral Policy Form.
Public employees: complete the Deduction Form and the Funeral Policy Form.
Optional: complete the Additional Member Funeral Form only if you want to add dependants to the cover.

Step 2 — Complete the online form & upload the completed documents

Fill in all required fields below and upload scanned copies of the forms you completed in Step 1. Fields marked with * are mandatory.

Upload a copy of your ID and the Funeral Policy form (required).
Important: you must upload at least one payment-authorisation form: either the Deduction Form (public) or the Direct Debit Form (private). The form names are separate on the page — you may upload either one.
The Additional Member Funeral Form is optional — upload only if adding dependants.
Accepted file types: PDF, JPG, JPEG, PNG. Maximum 2 MB per file.

Step 3 — Submit & wait for confirmation

Click Apply to submit.

Personal Information

First Name *

Surname *

Date of Birth *

Applicants must be at least 16 years old.

Gender *

Marital Status *

Nationality *

Applicant Contact Number *

Applicant Email Address *

Next of Kin Full Names *

Next of Kin Contact Number *

Applicant Physical Address *

Employment Sector *

Contract Type *

Name of Facility *

Occupation *

BHPC Number (starts with hp) *

Upload Documents

Please upload the completed forms and your ID document. Allowed formats: PDF, JPG, JPEG, PNG.

ID Document *

Deduction Form (Public)

If you are in Public, upload the Deduction Form.

Direct Debit Form (Private)

If you are in Private, upload the Direct Debit Form.

Please upload either the Deduction Form or the Direct Debit Form.

Insurance / Funeral Policy Form *

Additional Member Funeral Form (optional) Only upload this if you are adding additional family members to the funeral cover.