Tel: +27 (0) 12 683 8827 Fax: +27 (0) 86 511 4732 Ground Floor, Lakeview Building, 1277 Mike Crawford Avenue, Centurion 0157 PO Box 10994, Centurion, 0046 E-mail: saiipl@icon.co.za south african institute of intellectual property law Membership Enrolment Form Please type or print clearly: TITLE FIRST NAME LAST NAME POSTAL ADDRESS POSTAL CODE BUSINESS TELEPHONE FACSIMILE CELLULAR PHONE COUNTRY EMAIL EMPLOYER Select a Membership Category: Fellow Member ZAR 3600 Annually Eligibility: persons approved by the Council who have; a high standard of academic and practical experience; been admitted as an attorney; and passed the examinations set by the Patent Examination Board in terms of the Patents Act No57 of 1978 and the Patent Regulations ( as amended) and/or the Patent or Trade Mark examinations prescribed in the regulations, or Associate Member ZAR 3600 Annually Eligibility: The following are eligible for election as Associate Members: Persons approved by the Council and who can establish to the satisfaction of the Council that they have a reasonable knowledge of intellectual property law and; have passed the Group 1 Patent or Trade Mark examinations prescribed in the regulations; have adequate academic, professional and/or practical experience to justify election as a Member associate. An application for Associate Membership shall be supported by two Fellows, not being partners, employers, employees or co-employees of the candidate. Ordinary Member ZAR 1950 Annually Eligibility: Available to persons who have an interest in intellectual property law but do not meet the requirements Page 1 of 2 For Fellowship or Associate Members membership. Student Member ZAR 1500 Annually Eligibility: Available to persons who have a matriculation certificate or exemption and who intend to enrol for examinations for the purpose of becoming Fellows or Associate Members. A Student Member shall cease being a Student Member on being elected a Fellow or Associate Member or upon ceasing to be qualified to be a Student Member. Payment All orders must be prepaid. Cheque enclosed, in South African Rand, drawn at a South African Bank, payable to SAIIPL. Electronic Transfer (e-mail proof of payment to the Executive Officer, ML Grobler at saiipl@icon.co.za Membership applications received between January 1 and June 31 will be charged at full rate. Membership applications received between July 1 and September 30 will be charged at half the rate. Membership applications received between October 1 and December 31 will be free of charge. I hereby state that everything is correct on this form is true and correct and I qualify for the class of membership for which I am applying. I have read the Code of Ethics and Constitution of the SAIIPL in which the rules of professional conduct applicable to the profession, which members are obliged to observe in the conduct of their practices, are set out; I will abide by, conform with, and act within the spirit, as well as the letter, of the guidelines set out therein. I accept that it is my responsibility to adhere to the guidelines; I will abide by the regulations and rulings issued by Council of the Institute from time to time. Applicant’s Signature: An application shall be supported by a Fellow, employers, employees or co-employees of the candidate. In addition, proof of qualifications should be attached. As a service to our members, The SAIIPL will send your information and offers via e-mail and fax. Unless you inform us otherwise, your membership acts as a grant of permission for the SAIIPL to send such information to you. If you have any further questions, please call SAIIPL at +12 683 8827 or visit the SAIIPL website at www.saiipl.org.za Page 2 of 2