Become a Member

Complete the digital form below, or download a clean PDF copy if you prefer to fill it out manually.

Download the Application Form

If you'd rather not complete the electronic form, you can download the official Khen Grocery Scheme Membership Application Form. Print it, complete it manually, and return it via email or deliver it physically.

📄 Download Application Form (PDF)

Main Member Details

Full Name

Surname

ID Number

Marital Status

Home Address

Contact Details

Beneficiary Nomination

Additional Household Members

Add up to 9 members

Package Selection

Standard Package (KGS1) — R150.00 / month Premium Package (KGS2) — R350.00 / month

Note: The Packages have a R70.00 joining fee payable on registration & R35 per week

Upload Documents

Attach your ID (PDF, JPG, PNG)