amagp membership

AMAGP MEMBERSHIP REGISTRATION FORM

Personal Details

Surname:

Initials:

Known As (Optional):

Address

Home Address (Only City/Town and Province):

E Mail Address

Confirm E Mail Address

Contact Number

Cell Phone Number:

Identification Number

RSA ID or GEPF Pension number:

General Information

Government Department (where you currently work, or worked before retirement)

Assistance Offered

Are you prepared to offer your services on a voluntary basis to assist AMAGP with its activities?

Please Select an option

None Other

Please select one of these options.

If other, please specify assitance

Financial Aid

AMAGP does not charge membership fees, but it 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.