Membership Application Form

SECTION A – APPLICATION TYPE

Applying As *

Individual

Company / Organisation

Application Type *

New Membership

Re-instatement

Upgrade

SECTION B – MEMBERSHIP CATEGORY

Select Membership Category *

Company Membership CORRISA

R 6,600.00 / year

Individual Membership CORRISA

R 935.00 / year

Asset Membership Regional

R 17,250.00 / year

Asset Membership National

R 23,000.00 / year

Fellow member

R 1,100.00 / year

Individual Consultant Listing Fee

R 2,167.75 / year

Student Member

R 330.00 / year

For full-time students registered at a recognised tertiary institution and not yet working in the industry.

Universities

R 3,850.00 / year

SECTION C – PERSONAL DETAILS

Title

First Name(s) *

Surname *

Maiden Name

SA ID / Passport Number *

Date of Birth

Gender

Race

Person with Disability?

Seeing Rating

Hearing Rating

Communicating Rating

Walking Rating

Remembering Rating

Self-care Rating

Contact Details

Work Email *

Personal Email

Mobile *

Home / Work Phone

WhatsApp Number

Residential Address

Street Address *

Suburb

City

Postal Code

Country

Same as Physical Address

Postal Address (if different)

SECTION D – EMPLOYMENT & PAYMENT

Employer / Organisation Name *

Employment Sector *

Job Title / Designation *

Level / Grade

Years of Relevant Experience

VAT Number

Employer Telephone

Employer Email

Person to Receive Invoices (Email)

Employer Street Address

City

Postal Code

Country

Who will pay for your membership?

I will pay myself — invoices are issued in my name

My employer will pay — the employer above is invoiced (VAT & address required)

SECTION E – QUALIFICATIONS & EDUCATION

Highest Qualification

Modules Completed

NQF Level

Year Obtained

Institution / University

Modules Completed

Additional Qualifications (add your full qualification history)

Existing Professional Designations

Professional Bodies (select all that apply)

SAICA

SAIPA

SAIGA

CIMA

ACCA

IIA SA (Institute of Internal Auditors)

IRBA

Chartered Secretaries (CGISA)

SECTION F – SUPPORTING DOCUMENTS

Accepted formats: PDF, JPG, PNG, DOC, DOCX. Maximum 10MB per file. Multiple files can be attached per field.

1. Copy of ID / Passport *

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