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