CEASA Corporate Membership Online Application Form

Company Name
Company Registration Number
Postal Address
Postal Code
Physical Address (Only one required)
Telephone Number Including Area Code
Fax Number Including Area Code
Email Address to use for Association Notices
Company Logo (For Email or website linking. Please email your logo to the webmaster)
Website Address (If not available, the Email address provided above will be linked to your logo.)
Please provide us with a maximum of three descriptive sentences to be placed under your CEASA website logo.
Please provide us with the names of Individual CEASA members whom are employed by the Company. 

(At least 50% of all CEP's in your direct employ must be Individual CEASA members in good standing. If you use external CEP contractors rather, then please advise and provide us with their names.)


Declaration and Administration
Name of Person Submitting This Application
Cellular Phone Contact Number
The Company agrees to abide by the Constitution
Proposing CEASA Member (If none, leave blank)
Seconding CEASA Member (If none, leave blank)