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SECTION A : CATEGORIES OF ASSOCIATE MEMBERSHIP

Please indicate the category of associate membership that you are you applying for?
Category of Associate Member Examples Fee (per annum)
Reciprocal Membership Industry Assoc., Recycling Assoc.
Special Member Schools, Section 21's, NPO's, NGO's R100
Friends Consultants R300
Corporate Suppliers to PETCO R1000
  Recyclers R1600
  Waste Management Companies R1600
  Small Brand Owners R3000
  Small to Medium Retailers R5000
  Other Companies R5000

SECTION B : GENERAL INFORMATION

1. APPLICANT DETAILS

Trading Name of Business *
Name of Applicant *
Designation of Applicant *
Telephone Number *
Fax Number
Email Address
Mobile Number
Please note that all financial, shareholder and employee information supplied on this application form is required for statistical and research purposes and will be treated as confidential. It will not be made available to third parties without the consent of the member concerned.

2. BUSINESS DETAILS

Physical Address *
Suburb *
Town *
Code *
Postal Address *
Postal Town *
Postal Code *
Business Telephone Number * (if different to applicant)
Business Mobile Number (if different to applicant)
Business E-mail Address (if different to applicant)
Business Fax Number (if different to applicant)
Website Address
Email

3. CONTACT DETAILS

Contact Person Name and Surname
Contact Person Telephone Number
Contact Person Email Address

4. FINANCIAL INFORMATION (optional)

Legally registered business name
(if different to trading name)
Average Turnover *
VAT Registration Number
(Mandatory if turnover exceeds R1,000.000)
Sole Proprietor Partnership
Company Close Corporation
Association Not for Gain Estate / Trust
Private Company Public Company
Individual  
Business Registration Number (if applicable)
Date of Business Registration (if applicable)

5. SHAREHOLDERS PROFILE (Optional)

Black Empowerment Shareholding *

6. EMPLOYEE PROFILE (Optional)

Disabled
MALE | African
MALE | Coloured
MALE | White
MALE | Asian
FEMALE | African
FEMALE | Coloured
FEMALE | White
FEMALE | Asian
Management *
TOTAL

7. QUALITY ASSURANCE (Where Applicable)

Member of Packaging Council of SA (PACSA) YES
Member of National Recycling Forum (NRF) YES
Other Memberships (please specify)
ISO Rating
Verification Code
Enter the code from the image above
I understand that continued participation is subject to :
* The payment of all fees upon receipt of the invoice.
* Informing PETCO within 14 days of any changes relating to the information contained in this application.
* Compliance with the PETCO constitution, requirements and conditions for services rendered as amended from time to time.