KORSMAN CONSERVANCY Membership Application

KORSMAN CONSERVANCY

MEMBERSHIP APPLICATION
Name

First NameLast Name
Cell number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Interests (e.g. Bird watching)
Membership Type / Annual Fee (2026/7)
Click here for more information on membership types and benefits
Banking Details

Bank: Nedbank

Branch code: 198 765

Account Name: Korsman Conservancy

Account Number: 1903573408
Attach Proof of Payment

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By signing here I agree to abide by the constitution of Korsman Conservancy and understand that I /we attend Korsman Conservancy events and work parties at my/our own risk. I consent to Korsman Conservancy collecting and storing my personal data for communication purposes.
Date

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