Membership Application Form

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GENERAL INFORMATION

Surname *

Full First Names *

Postal Address *

Postal Code *

Residential Address *

Postal Code *

Telephone Home *

Telephone Business *

Fax No. *

Cell *

Email Address *

Date of Birth *

ID No. *

Upload a copy of your ID Document (or birth certificate for juniors)

Occupation *

Name of Employer *

CATEGORY OF MEMBERSHIP APPLIED FOR: (FEES APPLICABLE UNTIL 31/08/2020)

Membership Category	Entrance Fee	Annual Subs	Chasa CEO	Total incl. VAT
Ordinary Membership (21-65yrs)	R350	R1130	R50	R1530
Junior Membership (12-20yrs)	R0	R160		R160
Senior Membership (65+)	R350	R350		R700
Wife of existing member	R0	R325	R50	R375
Overseas Membership (ord. snr)	R400	R1360	R50	R1810
Overseas Junior Membership	R350	R460		R810
Associate Membership	R350	R470		R820
Child (0-11yrs)				FREE

OPTIONAL: Additional R150 contribution to receive the biannual Nyala News magazines

Yes

Tick to indicate the Branch of your choice: Have you ever been refused membership or been expelled from a Hunting & Conversation Association?

Yes

What are your reasons for joining the Association?

How can you assist the Association in achieving it's objectives?

PAYMENT OPTIONS:

A. Cheque or cash payments to the office (No cash by post please)
B. Direct deposit or Electronic Transfer -
Bank: FNB Pinetown
Branch Code: 221626
Account Number: 58880792280
Reference: Your tel no. and name
Fax proof to +27 (0)31 709 3914 or Email to hannelie@kznhunters.co.za

THE ASSOCIATION WILL TAKE NO RESPONSIBILITY FOR ANY FORMS AND/OR MONEY HANDED TO INDIVIDUAL MEMBERS. IT SHOULD BE SUBMITTED TO NATIONAL OFFICE AT 45 MAURICE NICHOLS ROAD, HATTON ESTATES, PINETOWN, 3610 OR P.O. BOX 782, WESTVILLE, 3630 (for postal items) OR E-MAILED TO hannelie@kznhunters.co.za OR FAXED TO +27 (0)31 709 3914

DECLARATION

Do you prefer an English or Afrikaans copy of "The Hunter's Handbook"?

English

Afrikaans

Name of Proposer *

Membership Number *

How long have you known the applicant? *

Name *

Date *

I, the undersigned, hereby declare solemnly that the above information is true and correct and that I have not been convicted of any offence involving or violence or been declared unfit to possess a firearm or found guilty of contravening any Nature Conservation Legislation. Should my application succeed, I pledge myself to abide by the Constitution an Rules of the Association.