Call Centre: 0861 00 8272

I hereby apply for membership of UASA. I undertake to abide by the Constitution of UASA at all times and realise that all the services and benefits linked to my specific membership option are subject to the terms and conditions that may be decided upon by the National Executive Committee from time to time. I do also understand that my membership will lapse after (1) month of nonpayment of my subscriptions.

Title(*)
Invalid Input

Surname(*)
Invalid Input

Full Names
Invalid Input

Postal Address
Invalid Input

Code
Invalid Input

Tel. No. (H):
Invalid Input

Cell No.
Invalid Input

ID No.
Invalid Input

Employer
Invalid Input

Sector / Industry / Company:
Invalid Input

(eg. Gold, Motor, Retail, etc.)

Home Address
Invalid Input

Code
Invalid Input

Tel. No. (W):
Invalid Input

E-mail
Invalid Input

Date of Birth
Invalid Input

Occupation/Position:
Invalid Input

Membership Options

Please Select Your Membership Option

Invalid Input

  • Legal and employee relations
  • Financial Wellness
  • UASA App
  • Marlicht Holiday Flats 10% discount
  • Emergency number 0861008272

Invalid Input

  • Legal and employee relations
  • Funeral - Once off R2500, main member only.
  • Financial Wellness
  • UASA App
  • Marlicht Holiday Flats 15% discount
  • Emergency number 0861008272

Invalid Input

  • Legal and employee relations
  • Funeral
  • Maternity
  • Study grant scheme
  • Financial Wellness
  • UASA App
  • Marlicht Holiday Flats 20% discount
  • Emergency number 0861008272

Names and Birth Dates of Spouse and Children

Name
Invalid Input

Name
Invalid Input

Name
Invalid Input

Name
Invalid Input

Name
Invalid Input

Date of Birth
/ / Invalid Input

Date of Birth
/ / Invalid Input

Date of Birth
/ / Invalid Input

Date of Birth
/ / Invalid Input

Date of Birth
/ / Invalid Input

UASA / Fincents and any of its accredited service providers may contact me for communication / marketing purposes:
Invalid Input

Recruiter No:
Invalid Input

Bank Debit Order


ID number
Invalid Input

Name of Bank
Invalid Input

Branch
Invalid Input

Branch Code
Invalid Input

Cell phone number
Invalid Input

Day of monthly debit order
Invalid Input

The first deduction should be made on (date)
Invalid Input