Hygiene Expert Membership

Membership Application

Initial Renewal

Surname

First Name(s) - In Full

ID / Passport Number

Country of Origin

Gender

Male Female

Equity

Black Coloured Indian White

Home Language

Disability Status

Nationality

E-mail Address

Tel No.

Cel No.

Postal Address

Physical Address

Municipality

Region

Current Status

Unemployed Temporarily Employed Permanently Employed

Name of Company

Current Position in Company

Duration

I agree to be added to the PBEH WhatsApp group chat

Yes No

Upload CV

Upload Certificates

Upload Certified Copy of ID/Passport

Upload CPD Evidence

Upload Letter of Reference

Upload Other Evidence

Mandatory: If not signed by the candidate, the application shall not be processed.

I understand and agree that by becoming a member of the Professional body for Environmental Hygiene, I shal adhere to the Constitution and the code of conduct of the organization and understake to support the objectives. I certify that statements made in this application and supporting documentationis true and correxct and neither my company nor myself had any involvement in the membership or designation approval. I give PBEH the necessary permission (as envisaged in the POPI Act) to share me personal details internally within the PBEH but only as may be necessary for the purposes of PBEH business

Cadidate Signature

Signature Date

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