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Affiliate membership
R
3000.00
Region
*
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KwaZulu-Natal
Northern Cape
Eastern Cape
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Western Cape
Limpopo
North West
Mpumalanga
Gauteng
Gender
*
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Male
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Name
*
Surname
ID Number
*
Postal Address
*
Employer Address
*
Health Professions Council Number
*
Tel (Work)
Cell Number
*
E-Mail
*
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Qualifications
*
Please capture as per the following format: Name of Qualification - Year Obtained - Institution Kindly email qualifications together with proof of payment to saiehnational@gmail.com
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Category:
Annual Subscription
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Associate Membership
R
600.00
EHP Student Membership
R
100.00
EHA Membership
R
200.00
