Loyal Aid
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Loyal Aid Registration
Personal Information
First Name
Last Name
ID Number
Email
Phone Area Code
Phone Number
Postal Address
Address Line 1 (e.g. PO Box)
Address Line 2 (Physical Address)
District
Suburb/Village
Zip Code
Banking Details
Payment Mode
Select Payment Mode
Monthly Subscription
Monthly Payment by hand
Bank Name
Select Bank
Standard Lesotho Bank
First National Bank (FNB)
Nedbank Lesotho
Post Bank Lesotho
EFT PAYMENT
Standard Bank Account
FNB Bank Account
Subscription Plan
Select Plan
Select a Plan
LOYALAID BASIC OPTION M100 - M100.00/month (100.00 points/month)
LOYALAID BASIC PLUS OPTION M200 - M200.00/month (200.00 points/month)
LOYALAID BRONZE OPTION M300 - M300.00/month (300.00 points/month)
LOYALAID SILVER OPTION M400 - M400.00/month (400.00 points/month)
LOYALAID SILVER PLUS OPTION M500 - M500.00/month (500.00 points/month)
LOYALAID GOLD OPTION M600 - M600.00/month (600.00 points/month)
LOYALAID PLATINUM OPTION M700+ - M700.00/month (700.00 points/month)
Payment Day of Month (1-31)
Dependents (Optional - Up to 4)
Dependent 1
First Name
Last Name
Date of Birth
Dependent 2
First Name
Last Name
Date of Birth
Dependent 3
First Name
Last Name
Date of Birth
Dependent 4
First Name
Last Name
Date of Birth
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