APPLICATION FOR MEMBERSHIP / UPGRADING

Please complete ALL fields

 
Surname : 
Name : 
Title :
Full Name for Certificate Purposes :
Age :
Date of Birth :
Identity No.
Residential Address :
Postal Address :
Tel No :
Fax No :
E-mail :
  
Employer Name :
Business Address :
Postal Address :
Work Tel No :
    
Is this a new application? Yes     No
If NO, what is your present grade :
Present member number (current members) :
 

PLEASE NOTE : APPLICATION FEE OF R200-00 ($20-00USD) MUST ACCOMPANY YOUR APPLICATION

   
EDUCATION AND TRAINING
Educational qualifications (substantiate by means of documentary evidence):
 
Professional / Registration / Membership of learned bodies (substantiate by means of documentary evidence).
Please state INSTITUTION, GRADE and DATE.:
 
EXPERIENCE
Give a complete list of all your experience (Starting with current employer and proceed to first employer).
Please state COMPANY, POSITION HELD, FROM/TO DATES:
 
Payment Method (*South African Applications only):       |      view DTMSI bank account details

Elec. Transfer   Draft    Cheque   Postal Order    Online (using PayPal)
Direct payment into DTMSI bank account*
Credit Card

For Credit Card Payment Only (complete ALL fields):

PLEASE NOTE: credit card details will be               
encrypted before transmitted over the Internet! 		We accept       
Credit card in the name of :
Credit Card Number :
Credit Card Type :
If Credit Card type is set to "OTHER" please enter :
Expiry Date : (Year)

(Month)
CVV Number
(Last 3 digits on back of card) :
Amount :
DTMSI Bank Account Details (Kindly fax a copy of your deposit slip for our convenience):
Bank First National Bank
Account Name Design, Technology and Management Society International
Account Type Current
Branch Code 20013
Account Number 62066368294
OVERSEAS SWIFT FRINZAJJ
Refer to the bank and the DTMSI account details as above
PLEASE ENSURE THAT YOU UNDERSTAND THE FOLLOWING:

DECLARATION BY THE CANDIDATE
By submitting this application, I certify that the above information is correct.

BEFORE SUBMITTING, PLEASE PRINT A COPY OF THIS FORM FOR YOUR RECORDS
   

 

VISA Mastercard American Express