Membership Application

Application for Active Membership

Membership Fees

R1750.00 annually. The membership period runs from 1 July to 31 June annually.
R5000.00 annually for supplier companies.
There will be a once-off administration fee of R320.00 applicable for new members.
Monthly debit orders are also available. Arrangements can be made with the CEO, Lynette Cokayne. Please view our Terms and Conditions

Please note: Fields marked with an asterisk (*) are required.

Company Representative Name:	*
Name of Business:	*
Postal Address:	Postal Code:
Physical Address:	Physical Code:
Area:	*
City:
Telephone:	* (Please fill in if you haven't entered a cellphone number)
Fax:
Cell:	* (Please fill in if you haven't entered a telephone number)
Email:
Web Site:

Please supply copies of the following: No application will be considered without the relevant faxed registration forms

Company/Close Corporation Reg. No.:
VAT Reg. No.:
PAYE Reg. No.:
UIF Reg. No.:
WCC Reg. No.:
Public Liability Insurance Policy No.:
Name of Insurance Company:
Maximum Cover:

Pest Control Operator's names and Department of Agriculture Reg. Nos.: Fax a copy of the current registration certificate	P:
	P:

Fax additional forms and documents to 086 674 7880