Individual Membership Application Form

* Required Fields

If you experience any problems or have any questions during the completion of this form, please contact WISA on 011 805 3537.

Profile Info

Title
Initials
First Name *
Last Name *
Birth Date
ID/Passport number *
Nationality *
Country *
Home Language *
Gender *
Ethnicity *
Occupation *
Company Name
Job Title

Contact Info

Home Number
Business Number
Fax
Mobile Number *
FaxToEmail
Email *
Alternative Email

Physical Address

Address Line 1
Address Line 2
Suburb
Town/City
Province
Country
Postal Code

Postal Address

Postal Line 1 *
Postal Line 2 *
Suburb *
Town/City *
Province *
Country *
Postal Code *

Additional Information

Disability
Hearing
Rate Disability (if any)
Communication
Seeing
Walking
Self-care
Remembering
Branch Membership
Select Division
Select Affiliations
May we send you newsletters, notifications and marketing material via SMS and Email?
May we publish your name and contact details in the annual member directory that is distributed to all WISA members, distributed at WISA events and sent to any person requesting a copy?
Are you interested in doing volunteer work for WISA Branches/Divisions/Head-Office?
How many hours are you available for volunteer work?
In which of the following ways do you want to be involved?
  • Branch/Division Committee member
  • Logistics
  • Promotions and Marketing
  • Assist in obtaining sponsorship
  • Writing articles for publication in WISA and main stream media
  • Being a mentor and/or specialist advisor
  • Visit schools and universities to promote WISA
  • Visit businesses and government departments to promote WISA
  • Man a "membership desk or exhibition stand" at WISA events hosted by other parties in the water sector to promote WISA membership and answer enquiries regarding WISA
  • Community outreach projects
  • Media mentor - reporting to WISA HQ all the news that is relevant to the Water sector and that needs our attention
Where did you hear about WISA?
Where did you hear about WISA? (if other)

Qualifications

Institute Qualification Name Qualification Type Start Date End Date

Employment History

Do you have any Employment History?

Application Checklist and Declaration

Declaration

By completing this form you agree to become a member of the Water Institute of Southern Africa and when admitted you agree to abide by the institutes Code of Conduct and Rules of the Company. You commit to pay promptly and in advance the annual subscription fee by 31 January of each year. You agree to generally promote the aims and objectives of the Institute and to enhance the environment.

(please tick this block to show that you agree to fulfil this declaration)

Upload Documents

Please upload the following documents which are required to process your application:
  • ID Document
  • Certificates for all the completed qualifications that you have listed on the application form.
  • Proof of registration if you are currently a full time student. (if applicable)
  • Proof of DWS registration. (only applicable for Professional Process Controller applications)
  • Proof of payment for the administration fee
Your application will not be processed until we receive the proof of payment.
Please visit the WISA website at www.wisa.org.za to view the administration and annual membership fee for each membership category.
You can upload your proof of payment below, or email it to debtors@wisa.org.za and wisa@wisa.org.za
File Type File Name

Banking Details

Account name: Water Institute of Southern Africa
Bank: First National Bank (FNB)
Branch: The Boulders
Branch code: 250856
Account number: 62044 55 2710
Please use your ID number as a reference on the payment.