www.jbayratepayers.

com
APPLICATION FOR MEMBERSHIP

SURNAME SURNAME

TITLE AND NAME KNOWN BY TITLE NAME KNOWN BY

NAMES OF MAJOR FAMILY MEMBERS SPOUSE PERSON 1 PERSON 2

HOME ADDRESS OWNER?

TENANT?

POSTAL ADDRESS

E-MAIL ADDRESS

TELEPHONE HOME WORK

CELLPHONE AND FAX CELLPHONE FAX

OPTIONAL
SHORT DESCRIPTION OF YOUR
WORK EXPERIENCE AND/OR
OTHER SPECIALITIES.
THE SAME OF YOUR SPOUSE AND
OTHER FAMILY MEMBERS.

I and my spouse/family support the Jeffreys Bay Ratepayers’ Association.

SIGNATURE DATE D D M M J J

Membership fees are determined annually.

OFFICE OFFICE
1. R40 per family for the period 1 January to 31 December.
USE USE
2. R20 per for any period between 1 July and 31 December.