Supplier Membership

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Membership Application

Initial Renewal

Company Registration Number

Core Business

Name of Company

E-Mail Address

Vat No.

Tel No.

Cel No.

Postal Address

Physical Address

Company Vat No.

Municipality

Region

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

Supplier Membership

Please complete the form below before proceeding to payment

Please complete the form below
before proceeding to payment