Membership Application Form

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APPLICATION FOR MEMBERSHIP OF SAFEX INTERNATIONAL
As the duly authorised representative of the undersigned Company, I hereby apply for membership of
SAFEX International and declare:
1. Our Company is a bona fide manufacturer of Explosives as envisaged in the SAFEX Articles of
Association
2. We agree to the SAFEX Secretary General acting on behalf of SAFEX Members.
3. We are willing to advise the SAFEX Secretary General of any incidents related to Health, Safety and the
Environment (HSE) from which the Explosives Industry can learn to improve its HSE performance.
4. We also undertake to report to the SAFEX Secretary General our findings or conclusions from any
investigations we may conduct following the initial incident advice. We understand we will not be
obliged to answer questions of a confidential nature contained in such an Investigation Report.
However, the Company will endeavour to supply as much information as possible and thus contribute
to the prevention of accidents in the Explosives Industry.
5. We understand that the SAFEX Secretary General will arrange for the information to be distributed to
Members and Associate Members of SAFEX International who have all undertaken to respect each
other's sensitivities.
6. We, in turn, will not divulge any information we obtain in the course of our association with SAFEX to
any third party. Nor will we use such information with the specific purpose of financial gain without
prior approval from the SAFEX Secretary General. We will not permit the indiscriminate use of such
information in any way that may be detrimental to the interests of any Member / Associate Member.
7. We undertake to update our member profile and contact details regularly in whatever manner the
SAFEX Secretary General prescribes. This will enable networking among the SAFEX membership as well
as assure uninterrupted information flow to and from the SAFEX Secretariat.
8. We can give notice of withdrawal from membership of SAFEX International at least one month prior to
the end of each calendar year. If no notice is given the membership will be automatically renewed for
periods of one calendar year.
9. We agree to pay both the entry fee, equivalent to the annual membership subscription, and the
annual subscription as specified in the invoice that will be issued by the Secretary General. We
understand that failure to pay our subscription by the date specified will result in suspension of our
access to information. The subscription is determined annually by the SAFEX Board of Governors.
KINDLY COMPLETE IN BLOCK LETTERS
COMPANY NAME
AUTHORISED
COMPANY
REPRESENTATIVE:
NOMINATION OF
COMPANY
CONTACT FOR
SAFEX
Title & Name
Position
Signature
Date
Title & Name
Position
Address
E-mail
Telephone
Telefax
Please return to SAFEX Secretariat:
E-mail: secretariat@safex-international.org ;
Tel / Fax: +27 11 7041743; .
Tel: +27 825565351
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