Membership application form

Become a member

All fields marked with * are compulsory.

Comments
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Personal information*
Titel**
Initials**
Name and Surname**
Name Surname
ID number**
Postal address
Postal code
Property*
Plot Nr**
Street name**
Suburb**
Number of Hectares**
Are you the Owner / Tenant*
Are you the Owner / Tenant
- Owner
- Tenant
Contact information*
Telephone home**
Telephone work**
Contact Person Cell nr 1**
Contact Person Cell nr 2**
E-mail address 1**
E-mail address 2**
I the undersigned, hereby give notice to the Apies River Rural Fire Protection Association (ARFPA) to be enrolled as member and undertake to subject myself to the ARFPA Constitution, regulations and Law on Veld and Forrest fires act 101 of 1998. I undertake to serve under the authority of the Fire Department and (ARFPA) management in best of my ability, if the need for it arises.
Completed and signed at**
Signature**
Date**
DD slash MM slash YYYY