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Membership Registration
Surname:
Name:
Gender:
Male
Female
Place of Birth:
Date of Birth:
Email:
Telephone (w):
Telephone (h):
Cell:
Occupation:
Postal Address:
P.O. Box:
Membership Fee of R200-00 per year paid by:
EFT
By Cheque
By Cash
We will provide you details after submission.
