Dermatology logo

Become A member

Dermatological Society of South Africa
I have recently been registered by the South African Medical and Dental Council as a and would like to join the Dermatological Society as:
 
Step 1:
 MEMBERSHIP TYPE: (please Tick)
Full Associate Affiliate
 
Details:
 Title
 Initials
 Surname
 First Name:
 Qualifications
 
 Postal Address
 
 
 Code
 Telephone (W)  Code  No:
 Facsimile (W)  Code  No:
 Cell Phone
 E-mail *
* please ensure you provide a valid email address
 I hereby apply for Membership of the DSSA:
 Proposed by 1: (Full member)
 Seconded by 1: (Full member)
 2: (Full member)
Anti-spam


Sum of 7 + 2 ?
 
 
Step 2:
Make Cheque payable to the DSSA, to the value of R300-00 inc VAT.
 
Step 3:
Post the Cheque to the DSSA treasurer at:
Bellville Medical Center
Room 1004
Blackenberg Street
7530

GALDERMA
 Copyright 2010 Dermatology | Website terms of use | Privacy Policy Admin
Powered By
E2