Online Application

Date of Application for Membership *

This is the date today

Indicate if this is a gift membership

Gift Membership
I wish to remain anonymous

Full Name of person buying gift

Membership being purchased by? Please give your full name

Cell phone number of person buying gift

Membership being purchased by? Please give your cell phone number so we can confirm items with you.

Main Member Details

Name *

First

Last

Date of Birth *

Main Member

Email *

Cell Phone *

Landline Phone *

Physical Address *

Unit No, Complex, Street

Suburb *

Kloof, Westville, Durban North etc

City *

Durban, Scottburgh, Pietermaritzburg etc

Zip Code *

Postal Address *

P.O. Box xxx, Area,

Additional Family Members

(only a spouse/partner and children under 18 may be added to your membership – each person is charged at the additional fee as indicated below)

Date of Birth

Name

First

Last

Mobile number of family member

Email address of family member

Date of Birth (Family member #2)

Name (copy)

First

Last

Mobile number (Family member #2)

Email address (Family member #2)

Date of Birth

Name

First

Last

Mobile number (Family member #2)

BeKZN Membership 2024 (please select all that apply) *

Main Member | R260.00
Main Member Senior | R220
Family member | R160 pp

Select all the relevant membership categories above which apply: Main Member | anyone between 18-60 years old Main Member Senior | >60 yrs) Family Member | this may only be a spouse/life partner/child <18 BLSA affiliation fee. PLEASE make sure you add if you are not already a member or joining here BirdLife South Africa. If you are a member of BirdLife South Africa you do not need to add the BLSA affiliation fee to your BeKZN total but you MUST provide your membership number in the block provided. Please then add up all the relevant memberships and fill in the total.

Total BeKZN (R) *

Sub-Total A

BirdLife eThekwini KZN

Online Application

BirdLife eThekwini KZN

Membership Form

Main Member Details

Additional Family Members

Payment Details

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BirdLife eThekwini KZN

Membership Form

Main Member Details

Additional Family Members

Payment Details

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