Masca Membership

Personal Details

Company Name:

Principal Member First Name(s):

Surname:

Age:

Date of Birth:

Postal Address: Home Address:

Telephone (Work):

Telephone (Home):

Email:

Sex: M F

Marital Status:

ID Number:

Weight (kg):

Height (cm):

Home Language:

Occupation: Industry (e.g., Mining):

Electronic Data (F.C.A.) Foreign Currency Account (US$)

Bank:

Account Number:

Account Name:

Swift Code:

Branch Code:

Previous MASCA Membership Number (if any):

Name of Medical Aid:

Medical Aid Number:

External Cover (Health International Group Limited):

Combo Suprema Package

Combo Prima Package

Principal Members

Principal Name:

Relation:

Address:

Comprehensive Corporate Health Plans

Premium Healthcare for Professionals

Flexible Healthcare Solutions for Medium-Sized Businesses

Family-Centric Healthcare Plans

Entry-Level Healthcare for Semi-Skilled Workers

Affordable Health Plans for Students

what’s new

Join Masca

Comprehensive Corporate Health Plans

Premium Healthcare for Professionals

Flexible Healthcare Solutions for Medium-Sized Businesses

Family-Centric Healthcare Plans

Entry-Level Healthcare for Semi-Skilled Workers

Affordable Health Plans for Students

what’s new

Join Masca

Become A Member

Application for Membership

Personal Details

Electronic Data (F.C.A.) Foreign Currency Account (US$)

Principal Members

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