New Membership Form
Name
*
First Name(s)
Surname
RSA ID Number
*
Please do not include spaces
Email
*
example@example.com
Phone (Work)
Please enter a valid phone number.
Format: 000 000 0000.
Phone (Mobile)
*
Please enter a valid phone number.
Format: 000 000 0000.
Address
*
Street Address
Street Address Line 2
Sarbub
Province
Area Code
Membership Type
*
Please Select
Individual
Company
Corporate
The following information will be used for statistic purposes only
Marital Status
Single
Married
Divorced
Widowed
Age Group
*
Please Select
18-25
26-35
36-45
46-55
55-Over
Contact Details of Spouse, Friend, Family Member or Business Associate
*
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Registered Name of Company
*
Company Trading Name
CIPC Registration Document
*
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Attach PDF Documents Only (10MB)
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Company Registration Number
*
CSD Registration Report
*
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Attach PDF Documents Only (10MB)
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of
TAX Clearance Certificate
*
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Attach PDF Documents Only (10MB)
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Company VAT Number
*
CIBD Registration Number
*
CIDB Grade
*
Please Select
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
NHBRC Registration Number
Optional / non-mandatory
Business Sector
*
Province
*
Please Select
KwaZulu-Natal
Eastern Cape
Gauteng
Free State
Limpopo
Northern Cape
North West
Western Cape
Region
*
District Municipality
*
Entity Type
*
Please Select
Individual CC
(Pty) Ltd
Co-Operative
Partnership
Joint Venture
Other (Government Department or NGO)
Latest Company Profile
Browse Files
Drag and drop files here
Choose a file
in PDF format only, size not <=10MB
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of
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Submit
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