SAASWIPP - Apply For Membership

South African Association of Social Workers in Private Practice

Membership Application Form

Please fill in the information below. Once you have submitted this form, you will receive an email with application forms which have to be completed and posted to us. Please note that there is an annual Registration Fee which applies to SAASWIPP Membership. Once you have been registered you will receive a username and password to update and add information to your profile.
(Please note, fields with a * are mandatory)

Title *		Initials *
First Name *		Surname *
Practice Address *		Postal Address
Province *
City *		Employed By
Practice Telephone No. *		Home Telephone No.
Work Telephone No.		Fax No.
Celphone No. *		Email Address * (Enter only 1 email address)
Council Reg No. *
Identity No. *		Work After Hours ?

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