INDIVIDUAL MEMBERSHIP

A. Personal Information

Title*

First Names*

Surname*

Chapter of Your Choice*

Please select the Chapter of Your Choice, in the province/city that you reside and work. NB: Northern Cape does not have a chapter yet

Cellphone Number*

Home Telephone

ID Number*

Date of Birth*

Race*

Gender*

Male
Female

Nationality*

Personal Residential Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Postal Address

If different from the above

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Are you a full time student or employed?

Student
Employed

B. Studies

Name of Institution*

B. Employment

Name of Employer*

Current Position*

Work Telephone

Have you been found guilty in a disciplinary hearing?*

If yes above, please provide details

C. Professional Registration and Membership

Are you a member of any Statutory Council, Board or Private Entity?

Please provide your membership number*

If you answered "Other" to the above, please provide the details, as well as your membership number:*

D. Career Promotion/Appointment

Please provide the details including the year in which it took place

E. Professional Development

Training or Courses

Please provide the details

Year, Institution, Course Particulars, Duration of Training Courses (e.g. 3 days/ 2 weeks etc)

F. Educational Qualifications

List all relevant qualifications applicable to the EAP Field*

H. Experience

Please summarise your current and previous experience in relations to the EAP Field

I: Upload Documents

Please upload the relevant documentation as PDF or Jpeg. Unfortunately word docs cannot be uploaded

Certified copy of your ID or Passport*

Stamp valid for 3 months

Drop files here or

Proof of Employment*

This can be your Employment Contract; Letter from Employer or Payslip

Drop files here or

Proof of Enrollment*

For your studies

Drop files here or

Curriculum Vitae*

Drop files here or

Certified copies of all qualifications*

Drop files here or

Copy of Statutory Council Registration

Drop files here or

Certified copies of courses attended

Drop files here or

Proof of attendance of courses or presentations for CPD Points (20)

Drop files here or

J: Declaration

By submitting the application, you accept and certify that all the information supplied by you is in all respects true and correct and that I remain bound by the EAPA-SA Constitution, Code of Ethics and Standards. Any misrepresentation can nullify this application. The EAPA SA Board reserves the right to accept/reject this application. Processing of your registration/order will commence as soon as we receive your payment. You will be notified within 10 working days whether you have satisfied the criteria for membership/designation. Designations can only be awarded when the designation committee convenes during Board meetings. EAPA-SA reserves the right to confer membership and designations.

Declaration*

By submitting the application, I accept and certify that all the information supplied by me is in all respects true and correct and that I remain bound by the EAPA-SA Constitution, Code of Ethics and Standards. Any misrepresentation can nullify this application. The EAPA SA Board reserves the right to accept/reject this application.

I agree to the terms of the Declaration

New Member: Individual Application Form

Step 1 of 3

Your Email Address

New Application or Renewing

A. Personal Information

B. Studies

B. Employment

C. Professional Registration and Membership

D. Career Promotion/Appointment

E. Professional Development

F. Educational Qualifications

H. Experience

I: Upload Documents

J: Declaration

New Member: Individual Application Form

Step 1 of 3

Your Email Address

New Application or Renewing

A. Personal Information

B. Studies

B. Employment

C. Professional Registration and Membership

D. Career Promotion/Appointment

E. Professional Development

F. Educational Qualifications

H. Experience

I: Upload Documents

J: Declaration

Subscribe