Join Safhe – Application Form

If you are interested in joining SAFHE as a member. Please fill in the following form. We will then contact you with further information.

First Name*
Last Name*
Date of birth*
Place of birth*
Email*
Phone number*
Your home or mobile phone number.
Work phone number
Your work phone number
Home address*
Postal address
* If different from home address
Occupation
Company
Why would you like to join SAFHE?*
Education, Training and Professional Qualifications
Secondary education*
Technical training
Tertiary education
Professional qualifications
Experience in the healthcare field in relation to the aims and objective of SAFHE: *
Notes:
After submission, the application is to be signed by a proposer and a seconder, who are SAFHE members in good standing. After approval of admission, membership will be granted subject to payment of the entrance fee and annual subscription. After two years of active membership, a certificate of membership will be issued. This certificate is required to be returned to SAFHE on cessation of membership. This application may be submitted to any of the regional representatives listed below:

Education, Training and Professional Qualifications