WHAT DOES IT COST? Annual membership fees for 2020 are: Professional R 450.00 Student R 370.00 Fellow R 450.00 Associate R 50.00 External R 450.00 International As above, in South African currency Late Payment fee of R30 will be charged after 28 February -oo0oo- Please answer the following questions: 1. What do you, as a prospective member of IMASA, expect from IMASA? 2. What do you have to offer IMASA? 3. Which province do you reside in? Eastern CapeFree StateGautengKwaZulu NatalLimpopoMpumalangaNorth WestNorthern CapeWestern CapeOther 4. Which municipality do you work at? APPLICATION FOR MEMBERSHIP MrMrsMsDrProf Your Surname (required) Your Full First Names (required) Address (where you receive your mail) Code Province Eastern CapeFree StateGautengKwaZulu NatalLimpopoMpumalangaNorth WestNorthern CapeWestern CapeOther Country Tel (w) Cell (w) Your Email (required) Date of Birth ID number Gender MaleFemale Race Academic Qualifications (Certified Proof to be submitted) Date Institution Qualification Employment Record in Municipal Administration (Certified Proof to be submitted) Employer Designation Period (From - To) Class of Membership Applied For: ProfessionalStudentFellowAssociateExternalInternational DECLARATION I agree to abide by IMASA's Constitution and any code of conduct that may be adopted by it, as amended from time to time. Signature Date I attach hereto: Proof of qualifications and service record Membership fee: EFT in favour of IMASACopy of deposit slip Bank details: North West & Free State Branch Limpopo & Mpumalanga Branch Western & Eastern Cape Branch Gauteng Branch ABSA Cheque Account ABSA ABSA ABSA Account No 406 609 6960 Account No 405 364 7394 Account No 404 903 8644 Account No 923 928 5769 Branch Code 334 249 Branch Code 334 410 Reference: Name & Surname
