Professional Service Provider Membership OR Goods Supplier Membership

Professional Service Provider Membership OR Goods Supplier Membership

Application form
Applying for:*

Professional Service Provider MembershipGoods Supplier Membership
Name of Company*
Main Business Function*
Main Business or Head Office address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website Address
Name of duly authorised representative of the applicant company*

First NameLast Name
Designation*
Mobile Number*

Area CodePhone Number
Landline Number*

Area CodePhone Number
Email Address*
example@example.com
Name of alternate duly authorised representative of the applicant company*

First NameLast Name
Designation*
Cell Phone Number*

Area CodePhone Number
Landline Number*

Area CodePhone Number
Email Address*
example@example.com
Is the applicant company a member of an industry representative body/ies or society/council and if so, name the industry body/ies or society/council.
What is your reason for membership with FASA?
Would the company be interested in participating in the Association's learnership program/s?*

YesNo
Upload company logo

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High resolution in JPG or PDF format Cancelof
Applicant Declaration - I agree to the following:*

I, the undersigned, who is the duly authorised representative of the applicant, acknowledge that the Franchise Association of South Africa (FASA) or any of its agents, financial institutions or credit bureau may conduct a credit check and exchange of such information on the applicant company for purposes of assessing the company as a potential member of FASA.As the duly authorised representative of the applicant company I agree and understand that membership of the Franchise Association of South Africa, once granted, continues annually unless the member company informs the Franchise Association of South Africa in writing, during the month of October of its intention to cancel its membership for the ensuing year.Should the Franchise Association of South Africa not receive a cancellation notification in writing during the month of October a membership invoice would be raised for the membership fees of the ensuing year and as the duly authorised representative of the applicant I agree and accept to abide by this membership policy.
How did you hear about the Association?
Do you consent to receive future emails, telephone calls or WhatsApp messages from FASA, including marketing content, industry news, event updates and opportunities. Please confirm by replaying YES or ticking the box below?*

Yes, I give my written consent to be contacted by FASA via email, WhatApp or phone for follow-up and marketing purposes.No, please do not send me any follow up communications.
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