Family feeling and professional approach
Diepkloof Zone 5 1862
24443/17 Baragwanath Road
24443/17 Baragwanath Road Diepkloof Zone 5 1862
011 024 7365

This is your application form for funeral cover on the Master Policy held by Mareana Style Funeral Service (Pty) Ltd. Please fill in all the relevant sections truthfully and in full using a black pen and make sure your answers are clear and readable. You must provide Mareana Style Funeral Service (Pty) Ltd with your identity document or driver’s licence and those of all the dependants you would like to add to your membership when you apply for cover. Please initial every page (at the bottom of the page).

Section A: Your personal details

Section B: What plan would you like to apply for (see your brochure for more details about the plans)?

Section C: Your dependants’ details Please see your brochure for details on the number of dependants you can add. We require proof of registration from the relevant school, college, university or other academic institution for dependent children who are 21 or older and full-time students.

Section D: Your additional extended dependants’ details You can add additional dependants to your cover. Additional extended dependants can be your biological parents, biological siblings, spouse, aunt, uncle, parents-in-law, sister-in-law, brother-in-law, step parents or grandparents. You can also add your spouse’s biological siblings.

SFS Application Form