Registration PM WARD ROUND Membership
Register at SASPEN
Title
Mr
Mrs
Miss
Ms
Dr
Prof
HPCSA (or Nursing Council) number
HPCSA number. eg. DT0012345, all in CAPITALS
First Name:
Last Name:
Where do you reside?
Western Cape
Gauteng
Other Provinces
Postal Address:
Postal Code:
Country:
NOTE
: For members residing 50km outside of Cape Town CBD or JHB/PTA CBD, participation is made possible through live video streaming via a closed Facebook group.
Work Number:
Cell Number:
Email Address
SASPEN Member?
Yes (R200 - Annual Fee)
No (R500 - Non Member Fee)
Category:
Physician/Surgeon
Nurse
Dietician
Pharmacist
Nutritionist
Other (please specify)
If Other:
Membership Category:
South African Member
South African Student Member
SADC Country Member
International Member
Contact Information