Join our waiting list Title Initials First Name Surname Date of birth Marital status Spouse/Partner Name Telephone Number Email Address Village —Please choose an option—Arbor Village – BedfordviewEddy House – Benoni CentralElandshaven – KlerksdorpFairleads Retirement Village – BenoniGarden Village – RandburgMontgomery Haven – Montgomery ParkPrim Villa – GermistonQueenswood Home – PretoriaRidgeview Village – BoksburgRose Village – Roosevelt ParkSamuel Broadbent House – PotchefstroomSprings Retirement Village – SpringsSummerfield Park – Johannesburg NorthSummit Village – Roodepoort Type of accommodation required —Please choose an option—Frail CareMid CareBoard & LodgingRentalPFU Room size —Please choose an option—Frail & Mid – single/multiLife RightsRentalBoard & Lodging bachelor1 bed2 bed I hereby give my consent to Methodist Homes for the Aged NPC (“Methodist Homes”) for my personal information to be collected and processed by Methodist Homes, for necessary processes within Methodist Homes which includes the provision of my care and residency within the home in which I will reside, which may also include internal administrative processing within Methodist Homes. I have read, understand and consent to the following POPI documentation Submit
