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BLACK CONVEYANCERS ASSOCIATION (BCA)
APPLICATION FOR MEMBERSHIP AND ACCREDITATION
I the undersigned hereby declare as follows:
Surname: _____________________________________________________________________
Name/s: _____________________________________________________________________
ID No: _____________________________________________________________________
Name of firms: _________________________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________
Code : _____________________________________________________________________
Tel. No: _____________________________________________________________________
Fax No: _____________________________________________________________________
Cell No.: _____________________________________________________________________
E-Mail: _____________________________________________________________________
Tertiary Education: ____________________________________________________________
Articleship:
Admission: (In which year):
Attorney:
. Conveyancer:
.
Law Society where registered:
Employment History:
Practice & BEE Status:
OWNERSHIP (Name of firm) :
Are you a Director/Member/Owner?
Black Ownership: % White Ownership: %
Details of involvement in any Association/Joint venture:
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(Full details of such Agreement are required. Do Annexure)
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Details of Profit sharing Agreements ( Where applicable)
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I hereby agree that in the event of false, incorrect or misleading information being provided that the BCA shall expel me and my firm with immediate effect.
Signature of Applicant
Commissioner of Oaths:
Signed and sworn before me at
. (place)
this the
day of
2006 by the above mentioned
who acknowledges that he/she knows and understands the contents of this affidavit
and that it is true and correct to the best of his/her knowledge and that he/she has no
objection to taking the prescribed oath and the said oath will be binding on his/her conscience.
Commissioner of Oaths________________________________________________________
Print Name ________________________________________________________
Date ________________________________________________________
Commissioner of Oaths Stamp
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