Please complete the application form below to apply for Sponsored WiBA Membership

PERSONAL INFORMATION

First Name

Last Name

Email Address

Cell number

BUSINESS INFORMATION - section 1

Company Name

Your Role/Position

Brief Description of Business

Years in current position

MOTIVATION FOR SPONSORSHIP

Please tell us why you are applying for sponsored membership

VAT Number (if applicable)

BILLING INFORMATION

Billing Address

Billing Address Line 2

City

Region/State/Province

Postal/Zip code

DECLARATION

We use Whatsapp to communicate with our members. I hereby give permission to be contacted on Whatsapp using the cellphone number I provided in this application.

I declare that the information above is true and correct.

I understand that I have signed up for a 12 month membership billed according to your selected application preference (annually, quarterly, monthly).

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Your Signature

THANK YOU FOR YOUR APPLICATION

A representative from our organisation will be in touch to finalise your membership.