Join UASA Stop Order – UASA Trade Union

I hereby apply for membership of UASA. I undertake to abide by the Constitution of UASA at all times and realise that all the services and benefits linked to my specific membership option are subject to the terms and conditions that may be decided upon by the National Executive Committee from time to time. I do also understand that my membership will lapse after (1) month of nonpayment of my subscriptions.

Title*

Surname*

Full Name*

Code

Tel. No. (H)

Tel. No. (W)

Cell No.

ID No.

Date of Birth

Employer

Occupation/Position:

Sector / Industry / Company

Names and Birth Dates of Spouse and Children

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

Name

Date of Birth

UASA / UFS and any of its accredited service providers may contact me for communication / marketing purposes:YesNo

Recruiter No: