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Join as a individual member

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* Required information.
Fullnames and Surname *
Initials *
ID no *
Physical Address *
Postal Address *
Postal Code *
Tel. Nr *
Cell. Nr. *
Fax Nr *
E-mail address *
Club Name ( if you are a member of a club )
Direct Via a club
Registration fee (Once off) R50,00 Registration fee (Once off) R50,00
Membership fee for private members (Annually) R250,00 Membership fee for private members (Annually) R125,00
Totaal: R300,00 Totaal: R175,00

Please fill in your intials and surname under "reference" on the deposit slip.

Send the deposit slip to Payments can be made to the following account:

PVSA, Posbus 664, Vryburg, 8600

Standard Bank Vryburg

Faks na 086 604 8084 Rek naam -  PVSA
Tak Kode: 050201
Tjek Rek no - 040 417 654

For more information please contact the PASA office - Tel 082 418 1555 (Weekdays 9am- 1pm)

For office use only:

Date Received
PVSA - Breeders Code

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