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	Annual membership fees for 2022 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

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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?

MrMrsMsDrProf
Your Surname (required)

Your Full First Names (required)

Postal address

Code

Province

Country

Tel (w)

Tel (h)

Fax

Cell (w)

Your Email (required)

Date of Birth

ID number

Gender
MaleFemale

Race
Asian/IndianBlackColouredWhite

Academic Qualifications

(Proof to be submitted)

Employment Record in Municipal Administration

(Proof to be submitted)

Class of Membership Applied For:
ProfessionalAssociateStudentSpecial

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 IMASAPostal orderCopy of deposit slip