Facilities Services Membership Application
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Please complete the form below
before proceeding to payment
Membership Application
Initial
Renewal
Company Registration Document
Company Registration Number
Core Business
Name of Company
E-Mail Address
Tel No.
Cel No.
Postal Address
Physical Address
Company Vat No.
Municipality
Region
Eastern Cape
Free State
Gauteng
KwaZulu-Nata
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
Contact Person
Contact Person Position
Contact Person Cell No.
Contact Person Email
Would you like to be added to the PBEH Whatsapp group?
Yes
No
MANDARTORY: If not signed by the association representative, the application shall not be processed
I, the authorized association representative, agree that, by becoming a member of the professional Body for Environmental Hygiene, out association shall adhere to the constitution and the code conduct of the organization and undertake to support it's objectives. I certify that statements made in this application and supporting documentation is true and correct and neither myself nor my company has any involvement in the membership approval. I give PBEH the necessary permission (as envisaged in the POPI Act) to share company details internally within the PBEH nut only as may be necessary for the purposes of the PBEH
Company Representative Name
Date
Company Representitive Signature
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