JOIN SAICRA NOW SAICRA Membership Application Form SECTION 1: COMPANY INFORMATION Name of Company Company Registration Number VAT Number DFFE Registration Number Physical Address Street Number & Name City Province Postal Code Postal Address P.O. Box / Street Name City Province Postal Code Telephone Website How did you hear about SAICRA? Website Referral Advertisement (Magazines, Billboards, etc.) Event/Conference Other If 'Other', specify Authorised Contact Person Name Position Email Telephone Cell Number Payment Contact Person Name Position Email Telephone Cell Number SECTION 2: OPERATION & REGULATORY DETAILS Primary Business Activity ManufacturerBrand OwnerImporterReconditioner Type of Packaging Used MetalPlastic Industry Sector Environmental Certifications Applicable Permits SECTION 3: FEE STRUCTURE Membership Type (Joining Fee) Manufacturer — R10 000Brand Owner — R15 000Importer — R25 000Reconditioner — R10 000Brand Owner and Importer — R25 000 Membership Plan Monthly — R1000Annual — R12 000 SECTION 4: ACKNOWLEDGEMENT & DECLARATION I acknowledge that an initial joining fee is payable.I agree to pay monthly EPR fees based on the quantities submitted.I confirm that I have read and understood the fee structure.I confirm that I will adhere to the Competition’s Act and SAICRA Code of Conduct.I consent to the Organization’s name being publicly listed as a SAICRA member.I confirm that all information provided is accurate and complete. SECTION 5: SIGNATURE Name Title / Designation Signature (Type Full Name)
