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Become an Eyakho Member

Complete the application form below to apply for an Eyakho Family Funeral Support plan. Please provide accurate information and upload all required documents so our team can process your application.

Need assistance? Call or WhatsApp us on 064 530 6165.

1. Personal Details

Please provide the personal details of the main member.

Title *

Full Names *

Surname *

Date of Birth *

ID/Passport Number *

Gender *MaleFemaleOther

Marital Status *SingleMarriedDivorcedWidowed

Home Language *

Nationality *

2. Contact Details

Please provide your current contact and address information.

Physical Address *

Postal Code *

Postal Address *

Postal Code *

Cellphone Number *

Alternative or Home Number

Email Address *

3. Beneficiary

Important: The beneficiary named below will be the only person authorised to claim if the main member is unavailable. No other person will be authorised to claim.

Beneficiary’s Full Names and Surname *

Beneficiary’s ID Number

Relationship to Main Member *

4. Dependants

Enter the details of the dependants who must be covered. Leave unused dependant sections blank.

Dependant 1 – Full Names

Dependant 1 – Date of Birth

Dependant 1 – Relationship to Main Member

Dependant 2 – Full Names

Dependant 2 – Date of Birth

Dependant 2 – Relationship to Main Member

Dependant 3 – Full Names

Dependant 3 – Date of Birth

Dependant 3 – Relationship to Main Member

Dependant 4 – Full Names

Dependant 4 – Date of Birth

Dependant 4 – Relationship to Main Member

Dependant 5 – Full Names

Dependant 5 – Date of Birth

Dependant 5 – Relationship to Main Member

Family plan dependant rules:

If a dependant child is older than 21 years, an additional R50 may be added to the premium.

By 30 years of age, the child is no longer eligible as a dependant.

5. Membership Plan and Payment

Select the membership option that is suitable for you. Plans start from R170 per month, depending on the selected plan and the main member’s age.

Select Your Membership Plan *Family/Extended Plan — Ages 0–65 — R170 per month — R18,000 coverSingle Plan — Ages 0–30 — R180 per month — R10,000 coverSingle Plan — Ages 30–50 — R220 per month — R18,000 coverSingle Plan — Ages 50–65 — R370 per month — R30,000 coverSenior Plan — Ages 65–75 — R450 per month — R45,000 coverSenior Plan — Ages 75–85 — R680 per month — R55,000 coverAdvanced Senior Plan — Ages 85–95 — R850 per month — R85,000 cover

Waiting period: A waiting period of six months applies to all new memberships. Full benefits become payable only after the waiting period has been completed.

Applicable fees:

• R1,000 compensation fee at the beginning of every year, subject to terms and conditions.

• R100 once-off main member fee.

Preferred Start Date *

Payment Frequency *MonthlyQuarterlyAnnually

Payment Method *EFTCash

Expected Payment Amount *

ZAR

Consent *

I understand that a six-month waiting period applies to new memberships.

I understand that the applicable annual compensation fee is R1,000, subject to the terms and conditions.

I understand that a once-off R100 main-member fee applies.

6. Supporting Documents

Upload clear and readable copies of the documents required to assess your application.

Main Member ID or Passport *

No file chosen

Beneficiary ID Document *

No file chosen

Proof of Residential Address *

No file chosen

Dependant IDs or Birth CertificatesOnly required if dependants are listed

Drag and Drop (or) Choose Files

Additional Supporting Document

No file chosen

7. Declaration

I hereby apply for membership with Eyakho Family Funeral Support. I declare that the information and documents supplied in this application are true and correct to the best of my knowledge. I understand the applicable premiums, waiting periods, fees and membership conditions.

Consent *

I consent to Eyakho Family Funeral Support processing my personal information and supporting documents for assessing and administering my membership application. I have read and accept the Privacy Policy and membership terms.

Applicant’s Full Name – Electronic Signature *Please take a picture of your signature and upload it.

No file chosen

Declaration Date *

Stay Connected

Contact us today about funeral support plans, membership information and Eyakho services.

Affordable, community-focused funeral support created to help South African families prepare for difficult times with dignity, compassion and peace of mind.

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Contact Eyakho

064 530 6165
Durban, KwaZulu-Natal, South Africa

Cover, benefits and monthly contributions are subject to eligibility and applicable terms and conditions.

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