PO Box 1101, Jeffreys Bay 6330 ---- www.jbayratepayers.

com

APPLICATION FOR MEMBERSHIP

SURNAME SURNAME

TITLE AND NAME KNOWN BY YOU YOUR SPOUSE

OTHER MAJOR FAMILY MEMBERS MAJOR FAMILY MEMBER 1 MAJOR FAMILY MEMBER 1

ADDRESS IN JEFFREYS BAY: RULE 1

HOME ADDRESS OR
PROPERTY ADDRESS
IN JEFFREYS BAY ADDRESS IN JEFFREYS BAY: RULE 2

ARE YOU THE OWNER OR OWNER TENANT (TICK THE APPLICABLE)

TENANT?

POSTAL ADDRESS POSTAL ADDRESS: RULE 1 POSTAL ADDRESS: RULE 2

E-MAIL ADDRESS E-MAIL ADDRESS

(IMPORTANT)

TELEPHONES HOME WORK

CELL PHONE AND FAX CELL PHONE FAX

OPTIONAL 1. YOUR WORK EXPERIENCE AND/OR SPECIALITIES.

SHORT DESCIPTION OF YOUR 2. YOUR SPOUSE’S EXPERIENCE AND/OR SPECIALITIES.

WORK EXPERIENCE OR OTHER
SPECIALITIES. 3. WORK EXPERIENCE AND/OR SPECIALITIES OF OTHER FAMILY MEMBER.
THE SAME OF YOUR SPOUSE
AND OTHER FAMILY MEMBERS. 4. WORK EXPERIENCE AND/OR SPECIALITIES OF OTHER FAMILY MEMBER.

I and my spouse/family support the SIGNATURE DATE

Jeffreys Bay Ratepayers’ Association

Membership fees are determined annually

AMOUNT RECEIVED AMOUNT
1. R40 per family for the period 1 January to 31 December.
2. R20 per family for the period 1 July to 31 December.
SIGNATURE
Banking details
DATE
ABSA, Jeffreys Bay, Cheque Account Number: 1940420527