ACCRA ACADEMY 90/92 YEAR GROUP
INVESTMENT CLUB

MEMBERSHIP APPLICATION AND PARTICIPATION AGREEMENT FORM

Please complete all sections accurately. All information is treated with strict confidentiality.

Fields marked * are required.

SECTION A: PERSONAL INFORMATION

1. Full Name *

2. Date of Birth *Unique

Duplicate entries will be rejected

3. Nationality *

4. Ghana Card / Identification Number *Unique

Duplicate entries will be rejected

5. Residential Address *

6. Postal Address

7. Occupation *

8. Employer / Business

9. Mobile Number *Unique

Duplicate entries will be rejected

10. Alternative Telephone

11. Email Address *Unique

Duplicate entries will be rejected

12. Accra Academy Year Group *

13. Membership Category *

Original Member Associate Member

SECTION B: NEXT OF KIN / BENEFICIARY DETAILS

Please name your Primary and (optionally) Secondary Beneficiary. Total percentage allocation must equal 100%.

Primary Beneficiary — Full Name *

Relationship *

Telephone Number *

Address *

Percentage Allocation (%) *

Secondary Beneficiary — Optional

Secondary Beneficiary — Full Name

Relationship

Telephone Number

Address

Percentage Allocation (%) — leave blank if none

SECTION C: CONTRIBUTION DETAILS

Initial Contribution Amount (GH¢) *

Preferred Contribution Method *

Bank Transfer Mobile Money Standing Order Other

If "Other" — please specify

SECTION D: MEMBER DECLARATIONS

By submitting this form, you declare that:

The information provided is true and correct.
You have read and agree to be bound by the Rules and Governance Framework of the Club.
You understand that investments involve risks and returns are not guaranteed.
You acknowledge membership is intended for long-term wealth creation and retirement preparedness.
You understand withdrawal restrictions before completion of five (5) years and applicable early withdrawal charges.
You agree to comply with all contribution requirements and lawful directives of the Club.
You understand delayed contributions may result in fewer investment units based on prevailing NAV.
You authorise the Club to maintain records relating to your membership and investments.
You agree to maintain confidentiality of Club information and affairs.
All funds contributed are derived from lawful sources.

Confirmation *

I confirm all declarations above and agree to the terms of membership

SECTION E: SOURCE OF FUNDS DECLARATION

I confirm that my contributions are derived from lawful sources and do not originate from any illegal activity.

My contributions shall primarily come from (select all that apply) *

If "Other" — please specify

SECTION F: DATA PROTECTION CONSENT

I consent to the collection, storage, processing, and use of my personal information by the Club solely for purposes relating to membership administration, investment management, regulatory compliance, communication, and beneficiary administration.

Data Protection Consent *

I consent to the collection and processing of my personal data as described above

SECTION G: APPLICANT CONFIRMATION

By typing your full name below you are providing your electronic signature and confirming the accuracy of all information submitted.

Applicant Full Name (Electronic Signature) *

Date of Submission *

SECTION I: FOR OFFICIAL USE ONLY

To be completed by Club officials only.

Application Received On

Membership Category (Official)

Application Approved

Yes No

Date Approved

Membership Number

Chairperson

Secretary

Remarks

ACCRA ACADEMY 90/92 YEAR GROUPINVESTMENT CLUB

ACCRA ACADEMY 90/92 YEAR GROUP
INVESTMENT CLUB