CRESTA PRIDE CONNECT CLUB SERVICES form: 2021/2022

Benefits and Conditions Home

Please check and edit the relevant information, then select Submit. Use the TAB button and mouse to navigate. AVOID THE ENTER BUTTON while filling in the form. Red asterisks (*) indicate required fields
Entry date:

Tuesday 21st September, 2021

Title:
Initials:
First names (personal name): *
Surname (family name): *
Postal address, line 1: *
Postal address, line 2:
Postal address, suburb:
Postal address, city: *
Postal address, province:
Postal address, code:
Postal address, country:
Company name:
Physical address, line 1:
Physical address, line 2:
Physical address, suburb:
Physical address, city:
Physical address, country:
Mobile phone: * please enter at least one contact phone (mobile or work or home) or email in the labelled fields
Work phone:
Home phone:
Fax:
Email: @
ID number:
ID type and country:
Occupation:
Birthday:
Wedding anniversary:
Mode of payment:
Direct banking: Deposit CRESTA LODGE GABORONE, Stanbic Bank, Fairgrounds Branch, A/C # 9060000434855, Branch code 064967. Please email the deposit slip to: connectadmin1@cresta.co.bw or fax to 390 0635, ensuring your name is on the slip
Payment arrangements:
Date for effecting payment arrangements:
Payment arrangements/ Collection advice/ Other notes to Cresta Pride Connect Club:
Existing Cresta card number is:






Benefits and Conditions Home

Site content copyright © Creative House (Pty) Ltd 2002-2021

Programme updated 7th June, 2021, 07:21. Made in Botswana by David Alexander Young 2005-2021