SACTA Registration Form - 2026
Name
*
First Name
Last Name
Title:
Please Select
Mr
Miss
Mrs
Dr
Prof
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer ( if applicable)
Select Category
*
Please Select
KTS
KT
KTG
Other
HPCSA number (Numerics only e.g. 0001234 ):
*
Practice number (if applicable):
ID number:
*
Category/Specialisation: (If student please select desired category)
*
Cardiology
Nephrology
Perfusion
Critical Care
Neurophysiology
Reproductive biology
Pulmonology
Are you willing to serve on a Task Team under your specialization?
*
Yes
No
Qualification/s:
Position:
Working for another Practitioner
Private Practice Owner
University
Research
Representative of Medical Company
Retired
Student
Government Sector Practitioner
Working for a corporate company like NRC/BBraun etc.
Other
If answered 'Student' above please upload proof of registration letter.
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Any other comments/suggestions about SACTA?
Have you paid for your 2025 SACTA member subscription?
Please Select
Yes
No
Student
Retiree
Previous Exco
If answered 'Yes' above please upload Proof of Payment for the annual amount of ZAR495
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