Membership Application

Surname(*)
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First Name(*)
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Title(*)
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Postal Address(*)
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Postal Address Code(*)
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Physical Address (if not same as postal)
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Physical Address Code
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Email Address(*)
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Company Name(*)
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Cell Number
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Work Tel. No.
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Job Title(*)
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Date of Birth
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Your organisation's principle business activity(*)
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If "Other" above, please specify
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Membership Option(*)
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*Corporate membership does not include the fees of Individual Case Managers but the individuals employed by the Corporate Member receives a 10% discount on the Member Fee.

The Terms, Conditions and Acknowledgements of this application are:
  1. I wish to become a member of the CMASA and hereby apply for membership.
  2. I agree to pay the subscriptions due.
  3. I understand that membership fees are non-refundable.
I have read, understand and accept the Terms and Conditions as above.(*)
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