INDIVIDUAL MEMBER = R 275-00
COUNTRY MEMBER = R 195-00
Please tick:
Individual....................
Country........................
Associate..............................
Please complete all sections clearly in BLOCK LETTERS
Surname:..............................................................................Initials........................Title............
First Name to appear on your membership card
..................................................……………
Identity Number:
.......................................Nationality..............RSA..............Other...................
Gender: ...........Male ..........Female
…………
Status:
Principal...........Employee....................Other.....................................................................
Residential Address: …………..................................................................................................
..................................................................................................Postal
Code: .............................
Tel: (h)..................................... Tel:
(w)................................Cell:
.............................................
Postal Address of Company:
……….........................................................................................
..........................................................................................…......Postal
Code: ...........................
Company Name:
…….................................................................................................................
Company Street Address:
….....................................................................................................
......................................................................................................................................................
Tel Code: ...................... Tel No.:
.............................Fax No.:
..................................................
E-mail address:
..........................................................................................................................
Website address:
.......................................................................................................................
Fidelity Fund Certificate
No.:....................................................................................................
Attach copy of your current Fidelity Fund Certificate
New
Categories (Please tick division in which you are most active):
Sales:
Residential......... Sectional Title......... C & I.........
Agricultural......... Auction.........
Admin/Rentals: Residential......... Sectional
Title......... C & I.........
New Categories Contd:
Broking: Business Broking...........
C & I............ Other: (developers, valuers, conveyancers,
mortgage, originators etc...............
Suburbs in which you operate:
..............................................................................................
How long
have you been in your present position: .............. Previous
Occupation ..............
Reference - preferably IEASA members: (This must be
filled in please)
Name:
................................................
Company:..........................Tel No:
...............................
Have you ever been a member of the Institute?
.........Yes ...........No If yes Region........................
Method of Payment: ...................Cheque
................Cash ..................Direct Deposit........................
1. I certify that the particulars given in
this application are true and correct.
2. I agree to be bound by the Memorandum
and Articles of Association and Regulations of the Institute (a copy
of which is available for inspection at the office of the Region).
Date:
....................................... Signature:
........................................................................
¨ The membership card
remains the property of the Institute of Estate Agents of South
Africa, and must
be returned on termination of membership.
Banking Details
First National Bank
Newton Park
Branch Code: 261-050
Account No.: 53460026570
Name: Institute of Estate Agents of SA
Please use your name as a reference on the deposit
slip and fax a copy thereof to 041-3642807.
FOR OFFICE USE ONLY
Receipt No:
........................ Date of Receipt:
............................ Membership
No:........................... Cash/Cheque