UBRRA MEMBERSHIP RENEWAL OR NEW MEMBERSHIP APPLICATION

For the Umdloti Beach Ratepayers & Residents Association (UBRRA)

Banking Details

Account name: Umdloti Beach Ratepayers & Residents Association
Bank: First National Bank
Branch: Umhlanga Crescent Branch Number 220629
Account No: 62770538521 (Current Account)

Your Reference:

Please use your FULL Name as a reference on the payment to ensure that we correctly credit your membership payment.This information will appear on our Bank Statement.

Please email your payment confirmation to ubra@emdlotiuip.co.za

When completing this form:

Fill in ALL THE FIELDS* marked with an asterisk
If something does not apply – type in N/A
Remember to answer the Math Sum
Then Click Submit
Should you experience a problem with the form, press CONTROL & F5 to refresh

Membership Renewal or New Membership Application for UBRRA

Name & Surname:*

Address:*

Email:*

Cell:*

I/We would like to renew/take out a membership subscription for UBRRA:* I/We would like to renew/take out a membership subscription for UBRRA:* New Membership Renew my membership

Please indicate subscription: Please indicate subscription: R100.00 per household R1000 per complex or commercial entity

Complex/Commercial name:

Acknowledge by ticking inside the box your permission for UBRRA to use your email address(s):* Acknowledge by ticking inside the box your permission for UBRRA to use your email address(s):* To comply with the Protection of Personal Information (POPI) Act, I hereby give UBRRA permission to use my email address to receive regular UBRRA newsletters and Updates.

Number

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