Official Membership Application

Membership Application

Please complete all required fields 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. Upload only one of Deduction Form / Direct Debit Form — not both.

Direct Debit Form (Private)

If you are in Private, upload the Direct Debit Form. Upload only one of Deduction Form / Direct Debit Form — not both.

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.