BASA Connect Membership Application
(Free membership for creatives)
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Creative Discipline
*
Brief Description of creative practice.
*
Years of experience
*
Please Select
0-1 Year
1-5 Years
5+ Years
Do you operate as a registered business?
*
Please Select
Yes
No
If Yes, please provide yes please provide your business name.
Company registration number
Briefly tell us what current work or most recent project you have done?
*
Key Achievements.
Industries that you collaborate with.
What opportunities are you intrested in?(select
*
Please Select
Funding opportunities
Corporate partnerships
Training/workshops
Networking events
Mentorships
How did you hear about BASA?
*
Have you previously participated in a BASA programme?
*
Please Select
Yes
No
If yes, which programme?
Consent to store personal information (POPIA compliance)
*
Please Select
Yes
No
Permission to feature member work on BASA platforms
*
Please Select
Yes
No
How did you hear about BASA membership?
*
BASA website
Social media
Email communication
BASA event
Referral from a BASA member
BASA team member
Other
If other, please specify
Submit
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