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Application Form

Personal Details
Title SANC/HPCSA Registration nr
SurnameFirst Names
Postal AddressTown
CodeProvince
Telephone Cell
Email
Work Details
Primary Employer
Employer/Hospital
Work Address Town
CodeProvince
TelephoneCell
Email
Professional Cat. Position/Rank
Involvement
Membership
Fees (Indicated by Type of Member): Payable on application and thereafter on 1 July of every year
Fees
Payment Method
  • Cheques & Postal orders should be crossed and made payable to the: RENAL CARE SOCIETY OF SOUTH AFRICA
  • Banking details:
    • Bank: Nedbank
    • Branch: Fourways (Code: 632005)
    • Branch Code: 198 765
    • Current Account Number: 1186789514
    Proof of payment to be emailed to info@renalcaresoc.org 
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