Individual Applicant

New Membership: R935 + R400 Admin Fee

Membership Renewal: Monthly Pro-Rata R935

Individual Information

Surname

First Names

Title

ID No

Physical Address

Postal Address

Highest Education

Country

Mobile No

Home No

Fax No

Email Private

Email Work

Employer Information

Company

Department

Position

Acc Email

Work No

Fax No

Physical Address

Postal Address

Which region do you fall under?

Region

Gauteng

KwaZulu-Natal

Cape

Other

If other, Please specify

Applicant's Declaration

I agree to the following:

We hereby apply to be admitted as a Company Member of the Corrosion Institute of Southern Africa, and we do solemnly and sincerely declare
that in the event of our election as a Company Member of the Institute, we will at all times observe the provisions of the constitution and the
By-laws thereof and will conduct ourselves honourably in the practice of our companies profession, and to the utmost of our power will
maintain the dignity and welfare of the Institute, by adhering to the code of ethics as defined in the Constitution.

Benefits of being a member

Become a Member

Individual Member

Company Member

Individual Information

Employer Information

Which region do you fall under?

Applicant's Declaration