Membership Application

Please complete the form in full for record purposes.

Membership Application

New Member:    Current Member:    Change of Address:    Gift Membership: 

Subscription for:              

Admission: R 25
One Year: R 150
Five Years: R 600
Donation:

 Total:

Name

Postal address with Code

E - mail address

Tel no (h) & (w)

I enclose payment for the above via:

Cheque   Postal Order  Bank Draft Internet

Please fax us a deposit slip as proof of payment into the Society's account: ABSA  Hercules, Acc No 1000870818, Branch Code 632005.         
I agree to abide by and comply with the constitution of the Society. Please make all payments payable to The South African Palm Society.
Fax Number: 27 (0)86 679 8045