Application for Membership
If you/your company want(s) to become a member of WOESA, then please complete this form in full
Company Name:
Trading Name:
Contact Person
Username (Email):
Physical Address:
Postal Address:
Address Code:
Postal Code:
Phone:
Fax:
Cell:
Website:
Position of Contact Person in Company:
Line of Business:
CEO / Owner / Partner
Senior management / Director
Middle management
Junior management
Professional (private practice)
Sales Rep / Distributor
Other
If Other Please specify:
Approximate turnover per annum
Less than R 50 000
R 50 000 – R 200 000
R 200 000 – R 1m
R 1m – R 5m
R 5m – R 20m
R 20m – R 200m
R 200m +
Education / Academic / Teaching
Government / Public Service
Exploration
Trading
Distribution
Gas
Retail
Liquid Fuel
Wholesaler
Electricity
Renewable Energy
Other
If Other Please specify:
Type of Membership Fees
Corporate Member
R 25 000
Company Member
R 10 000
Company Member(PDI's and SMME's)
R 2 500
Individual Employee
R 1 000
Professional Organisation Memberships (e.g. NAFCOC):
Banking Details
Account Name:
WOESA (Women in Oil and Energy SA)
Bank:
ABSA Bank Limited
Branch Name:
Rosebank
Account Number:
9215603541
Branch Code:
632005
Type of Account:
Current Account
Details:
First 5 digits of ID Number and initials and Surname
Copyright © WOESA 2009
