AMAGP MEMBERSHIP REGISTRATION FORM
Personal Details
Surname:
Initials:
Full Name/s:
Address
House Number and Street:
Suburb:
City:
Postal Code:
E Mail Address:
Confirm E Mail Address:
Contact Number
Cell Phone Number:
Enter your cellphone number (0831234567)
Identification Number
RSA ID Number:
General Information
Government Department (where you work, or worked before retirement)
Assistance Offered
Are you prepared to offer your services on a voluntary basis to assist AMAGP with its activities? (Indicate your assistance)
Please select one option
None
Administrative
Legal
IT
Website
Fundraising
Support
Other
Please select at least one option
Financial Aid
AMAGP urgently needs funds required for administrative and legal expenses.
You are kindly requested to make a voluntary monthly contribution of R100 or any other amount that you can afford.
Amount Offered:
It would be appreciated if you could sign a stop order in favour of AMAGP at your bank or make payment via "EFT", but no
cash deposits, as the banks do levy a substantial deposit fee on cash deposits.
AMAGP Banking Details
Bank: First National Bank
Account Name: AMAGP
Account Number: 62743347454
Branch Code: 251345
AMAGP WEBSITE
https://www.amagp.co.za