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Province of Residence * Eastern CapeFree StateGautengKwaZulu-NatalLimpopo ProvinceMpumalangaNorthern CapeNorth WestWestern Cape
Membership type * Full MembershipAssociate Membership
Please indicate your area/s of interest in the industry * Pension LawIndependent Principal OfficerIndependent TrusteeInvestment AdvisorMediatorActuaryAuditAdministration
PERSONAL DETAILS
Title * Please select: Mr.Mrs.MissMs.Dr.Prof.
First Name(s) *
Surname *
Date of Birth * eg. DD/MM/YYYY
ID Number *
Telephone: Home eg. 0214440000 (10 digits, no spaces)
Telephone: Work * eg. 0214440000 (10 digits, no spaces)
Fax eg. 0864440000 (10 digits, no spaces)
Cellphone * eg. 0834440000 (10 digits, no spaces)
Email Address *
Postal Address *
Postal Code *
CURRENT EMPLOYMENT
Current Employer *
Current Occupation *
Have you been admitted to practise as an: (if applicable) AttorneyAdvocate
LISTING
Do you wish for your details to be listed under the resources tab and be visible to the general public? * YesNo
Under which category would you like your details to be listed? Only applicable if you selected 'yes' above Pension LawIndependent TrusteeIndependent Principal OfficerMediatorActuaryInvestment AdvisorAuditAdministration
PAYMENT
Membership fees for the period 1 January 2017 to 31 December 2017: Initial Joining Administration fee: R200.00 (including VAT) Annual fee: R700.00 (including VAT) (R350.00 for half-year)
If your employer firm will pay your subscription please provide the following:
Name of Organisation
Billing Address
VAT registration number for invoicing
DECLARATION
I, the undersigned, hereby declare that the information provided in this application form is true and correct.
I also agree to abide by the Constitution of the Pension Lawyers Association of South Africa as well as all other regulations that might be promulgated by the Committee.
Signed * (Full name)
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