New Member Application Membership Form We are thrilled that you are interested in becoming a NNASA member! We look forward to welcoming you at one of our upcoming events. ANNUAL MEMBERSHIP FEE: R350.00 (applicable for 12 months from receipt of payment) How do you benefit: Membership of the NNASA Membership badge Membership of the Council of International Neonatal Nurses (COINN) Discounts applicable for conferences and workshops Networking through Regional branches and NNASA WhatsApp groups NNASA website for online resources, position statements and blog post Please complete the form below to become a member of NNASA. Please contact us at info@nnasa.org.za if you have any questions or experience any problems.Personal DetailsPrefixMr.Mrs.Ms.Mx.MissDr.Prof.First NameLast NameID Number/Date of Birth *Your email *Contact Number *Statutory Body and Registration NumberPostal Address *Statistical InformationFor statistical purposes only please advise on the belowOrganisation/Department/Municipality/HospitalSelectEastern CapeFree StateGautengKwaZulu-NatalMpumalangaNorthern CapeLimpopoWestern CapeNorthwestOtherSectorPrivatePublicGenderMaleFemaleOtherRaceNeonatal ExperienceNeonatal ExperienceWhat Neonatal training do you have?Have you participated in Neonatal Research? If yes, which?Position/DesignationUnit ManagerRegistered NurseEnrolled NurseLecturerOtherIf other, please specify:Would you like to start a Branch in your area?YesNoPlease provide more information.Please indicate if you would NOT like to be included in either of the communication platformsI do not want to recieve communication from the Mailing ListI do not want to recieve communication from theWhatsApp GroupsI want to subscribe to bothI do NOT want to recieve communication on either platformsPayment DetailsPayment DetailsOnce your registration form has been processed, an invoice with bank details will be forwarded to you for payment. Please note that payment is only to be made on receipt of invoice. Once your initial payment has been processed you will receive: A welcome letter A membership certificate A membership badge Our Vision, Mission and Core values Receipt of payment Please kindly indicate your intended method of paymentBANK DEPOSITELECTRONIC TRANSFERCASHPlease ensure all transfers make clear reference to the member being paid for, i.e., Joe Soap (Name and Surname).Once payment has been made, the proof of payment is to be e-mailed to treasurer@nnasa.org.za.Terms & Conditions: The membership fees will be applicable for the period of 12 months from date of payment received. No membership will be confirmed without payment. Confirmation of payment received will be provided in the form of an official receipt. Without a proof of payment, you will not be receipted, and your membership cannot be processed. Value Added Tax:In accordance with the South African Revenue Services (SARS), 15% has been included in your membership fee. The percentage is subject to change based on SARS. Privacy Statement: We collect information that you voluntarily provide, for us to process memberships and other transactions that you may request, provide a customer service, and obtain statistical data.We use your information to inform you of updates and send you relevant information regarding the concerned event.We do not sell, rent, or lease our delegate lists to third parties.To help provide our services, we occasionally provide information to other companies that work on our behalf. The Neonatal Nurses Association of Southern Africa (NNASA) and any company used by NNASA shall take all reasonable steps to protect the personal information of users. For this clause, "personal information" shall be defined as detailed in the Promotion of Access to Information Act 2 of 2000 (PAIA). The PAIA may be downloaded from: http://www.polity.org.za/html/govdocs/legislation/2000/act2.pdfConsent *Yes, I agree with the privacy policy and terms and conditions.SubmitSave and Continue Later