E-Mandate

Electronic debit order mandates for your business.

(LS) #66 COP001 – COPE

Electronic debit order agreement

Province*
Authority given by:
Name*
First Last
Gender*
- Male
- Female
ID Number*
Residential Address*
Street Address Address Line 2 City Postal Code
Telephone Number*
Cell Number*
Email Address*
Date of Birth*
Date Format: DD slash MM slash YYYY
Marital Status*
Number of Dependents*
Race
For statistical reasons only
Home Language*
Religion
For statistical reasons only
Highest Education Level
For statistical reasons only
Employment Type
For statistical reasons only
Occupation
For statistical reasons only
Ward Number*
Find your ward number here.
Membership fees:
Membership Fees Paid for*
Membership*
- COPE Membership (R30/year)
- COPE WM
- COPE YM
- COPE SM
- COPE B&P
Total Membership for:*
Contract amount
How would you like to pay for your membership?*
Bank account details:
Bank*
Branch code*
Account number*
Type of account*
Credit card details:
Credit Card*

MasterCard
Visa
Card Number Expiration Date CVV Number Cardholder Name
Manual historic payment:
Deposit Date*
Date Format: MM slash DD slash YYYY
Deposit Amount*
Deposit Reference Number*
Agreement:
Abbreviated short name as registered with the acquiring bank: COPE
Refer to our contract reference number (“the Contract Reference Number”):
Reference*
Annual debit date*
Date Format: DD slash MM slash YYYY
I confirm I subscribe to*
- COPE Constitution
- COPE Policies
- Code of Conduct
Membership declaration*
I SOLEMNLY DECLARE THAT, FROM THE TIME I AM RECOGNISED AS A BONA FIDE MEMBER OF THE CONGRESS OF THE PEOPLE (COPE), AND TO THAT EFFECT ACCEPT MY MEMBERSHIP CARD, AND FOR AS LONG AS REMAIN A MEMBER;
1. I SHALL BE A PATRIOTIC SOUTH AFRICAN, and accordingly discharge my responsibility to protect, and defend the Constitution of the Republic of South Africa, to exercise my right and responsibility to vote at all times, and mobilise other South Africans to do the same, and to defend our hard won freedom by contributing to building a prosperous country for all.
2. I SHALL ABIDE BY, AND BE LOYAL TO, THE CONSTITUTION OF THE CONGRESS OF THE PEOPLE, a party with its historic roots in the congress movement of our country whose vision for South Africa, the Freedom Charter , was adopted at the Congress of the People in Kliptown in 1955;
3. I SHALL MOBILSE SOUTH AFRICANS TO JOIN, SUPPORT AND/OR VOTE FOR THE CONGRESS OF THE PEOPLE and contribute to making it the natural political home for all South Africans committed to building a country of prosperity for all, in which all citizens are, and feel, protected to exercise their rights and responsibilities without fear or favour, as well as avail myself to serve the Party where I feel competent and ready while respecting the decision of the Party on that as final;
4. I SHALL RESPECT THE PARTY AND SOCIETAL VALUES seeking at all times to align, through my conduct and pronouncements, the broader societal values with those of the Party, respect and protect all the Party and national symbols as well as the oath of public office;
5. I SHALL TREAT ALL PARTY MEETINGS, CONFERENCES AND CONGRESSES WITH UTMOST RESPECT, GUARD THEIR INTEGRITY AND UPHOLD THEIR DIGNITY, recognising their critical role as centres of entrenching a solid culture of participatory, accountable and democratic governance in the Party and therefore society, will prepare myself to contribute effectively in the meetings to ensure their successful conclusion, and will not, unless so officially authorised, divulge the content or any aspect of what takes place in them to any third party, gathering, the media, social media or any form of electronic or other public communication means, failing which such conduct shall be a serious misconduct and be subject to the Party’s disciplinary processes;
6. I SHALL RESPECT AND ABIDE BY THE DECISIONS OF THE PARTY and not denounce such decisions or attack the character or person of, or disrespect in any way, any leader or member of the Party, to or through any third party, gathering, the media, social media or any form of electronic or other public communication means, or act in any way that may bring confusion in the minds of the members of the Party or public or saw division or factionalism in the ranks of the Party;
7. I SHALL CONTRIBUTE TO ENSURING FREE AND FAIR ELECTIONS IN THE PARTY and country, respect the leadership elected, and if not satisfied and believe that the results of the elections may be, or have been, compromised in any way, I will use proper channels and procedures agreed to respect the final outcomes of such processes, procedures or structures;
8. I SHALL ABIDE BY THE PARTY CODE OF CONDUCT, DISCIPLINARY POLICY AND PROCESSES and shall not do anything that may bring the name of the Party or the country into disrepute or behave in a manner that is in any way divisive, factional or amounts to the abuse of power;
9. I SHALL AT ALL TIMES CONDUCT MYSELF IN A MANNER THAT INSPIRES HOPE as well as represents and carries the aspirations of all the people of South Africa in their diversity;
10. I SHALL CONTRIBUTE TO ENSURING THAT OUR PARTY AND COUNTRY play their respective roles as forces for progressive change and stability for a better Africa and humane world based on a human rights culture that respects the equality of peoples and nations in principle and in practice.
- I have read, understood and agree to abide by the Membership Declaration set out above.
Terms of agreement
I hereby authorise you to issue and deliver payment instructions to your banker for collection against my above mentioned account at my above mentioned bank (or any other bank or branch to which I may transfer my account) on condition that the sum of such payment instructions will never exceed my obligations as agreed to in the donation agreement and commencing on the payment date as selected above and continuing until this authority and mandate is terminated by me by giving you notice in writing of not less than 20 ordinary working days, and sent by email. I understand that the withdrawals hereby authorised will be processed through a computerised system provided by the South African Banks and I also understand that the details of each withdrawal will be printed on my bank statement. I understand that my bank will apply charges at their ruling rates for unmet transactions. I also understand that any banking fees incurred by the Congress of the People may be recovered of unmet transactions. If the payment day falls on a Sunday or recognised South African public holiday, the payment will automatically be processed the next ordinary business day. I authorise the originator to make use of the tracking facility as provided for in the EDO system at no additional cost to myself. ASSIGNMENT I acknowledge that this authority may be ceded or assigned to a third party if the Agreement is also ceded or assigned to that third party, but in the absence of such assignment of the Agreement, this Authority and Mandate cannot be assigned to any third party. CANCELLATION I agree that although this Authority and Mandate may be cancelled by me, I shall not be entitled to any refunds of amounts which you have withdrawn while this authority was in force if such amounts were legally owing to you. I understand that cancellations may only take effect a month later.
Signature*
Signature verified by Bank

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Authority given by:

Membership fees:

Bank account details:

Credit card details:

Manual historic payment:

Agreement: