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Province of Residence * Eastern Cape Free State Gauteng KwaZulu-Natal Limpopo Province Mpumalanga Northern Cape North West Western Cape
Membership type * Full Membership Associate Membership
Please indicate your area/s of interest in the industry * Pension Law Independent Principal Officer Independent Trustee Investment Advisor Mediator Actuary Audit Administration
PERSONAL DETAILS
Title * Please select: Mr.Mrs.MissMs.Dr.Prof.
Surname *
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Date of Birth * eg. DD/MM/YYYY
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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) Attorney Advocate
LISTING
Do you wish for your details to be listed under the resources tab and be visible to the general public? * Yes No
Under which category would you like your details to be listed? Only applicable if you selected 'yes' above Pension Law Independent Trustee Independent Principal Officer Mediator Actuary Investment Advisor Audit Administration
PAYMENT
Membership fees for the period 1 January 2012 to 31 December 2012: 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
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.
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