SASGO Members Application form 2015

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SOUTH AFRICAN SOCIETY FOR GYNAECOLOGIC ONCOLOGY
MEMBERSHIP FORM
MEMBERSHIP BENEFITS INCLUDE:
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Guaranteed circulation of the SAJGO
Access to free medicolegal advice from the peer group
Access to the society website and the e-journal (www.sajgo.co.za)
Notification of international and national meetings
Discounted attendance at congresses
NAME
ADDRESS
POSTAL ADDRESS
TELEPHONE
CELLPHONE
E-MAIL
• Full Membership:
Gynaecologic oncologists registered with HPCSA
MEMBERSHIP
CATEGORY
• Associate Membership:
Fellows in training, general gynaecologists, radiation oncologists,
medical oncologists, anatomical pathologists, clinical pathologists,
oncology sisters
HPCSA MEMBERSHIP NUMBER
PAYMENT (Please tick appropriate fee)
Full membership:
Annual fee: R750.00
Associate membership:
Annual fee: R500.00
ELECTRONIC PAYMENT
FNB Account number 62096292174
Branch number 200109
Please include surname and initials as reference when paying online and send completed membership form to
sasgopost@gmail.com, or fax 086 570 2690 or post SASGO, UP GO unit, PO Box 2450, Brooklyn Square, 0075
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