MEMBERSHIP APPLICATION FORM
1. I HEREBY APPLY FOR MEMBERSHIP AND UNDERTAKE TO ABIDE BY THE RULES
AND REGULATIONS OF THE SOCIETY.
Name:
Place:
Date:
(dd/mm/yy)
I UNDERSTAND THAT IF MY APPLICATION IS SUCCESSFUL, I WILL PAY THE REGISTRATION FEE (R60.00) AND MEMBERSHIP FEE FOR 2008 (R203.00)
2. FOR OFFICE USE /
VIR KANTOOR GEBRUIK
Membership Number/
Lidmaatskapnommer
/:
Date Received/
Datum ontvang
:
Date Council Meeting/
Datum Raadsvergadering
:
Type Membership awarded /
Tipe Lidmaatskap toegeken
:
Full/
Volle
or Student
APPLICATON APPROVED
AANSOEK GOEDGEKEUR
SIGNATURE/
HANDTEKENING
SECRETARY/
SEKRETARIS
Please complete the questionnaire below and then click the SUBMIT button
.
SSSSA QUESTIONNAIRE
1. PERSONAL INFORMATION
(Please provide comprehensive information)
Surname:
First Names:
Title:
Postal Address:
Postal Code:
Tel.Code:
Tel.Number:
Fax Number:
Email address:
Language:
English
Afrikaans
ID Number:
Present Employer:
Address of Employer:
2. QUALIFICATIONS
Qualification + (Year)
Institution
Major Subjects
3. FIELD OF WORK
(Please mark appropriate blocks, maximum of 3)
Soil Physics
Soil Chemistry
Soil Biology
Soil Fertility
Soil Genesis
Soil Mineralogy
Soil Technology
Other (specify):
4. EXPERIENCE
Employer
Type of Experience
Period
5. AFFILITATION TO OTHER SCIENTIFIC AND PROFESSIONAL SOCIETIES
Society/Organisation
Member or Office Bearer
Period
6. NUMBER OF PUBLICATIONS
(Please enter a number in the appropriate blocks)
Scientific
Popular
Reports
Books/Chapters
7. NUMBER OF PAPERS PRESENTED
(Please enter a number in the appropriate blocks)
International
Local
