IT Service Management - itSMF

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Registration

Please remember to select the applicable mailing list from the selection below

For Individual Memberships: Please Complete Section 1

For Vendor & Corporate Memberships: Please complete Section 1 and Section 2

Name:

Username:

E-mail:

Password:

Verify Password:

Select your mailing list:

Select Your Region:

__________________________________________________________________________

Section 1 - Membership Application

Please note that for each individual belonging to a company a separate application form needs to be filled in

Select your membership type:

Individual	Vendor 10	Corporate 10
Vendor Single	Vendor Unlimited	Corporate Unlimited
Vendor 5	Corporate 5	Corporate 2

Member details:

Tel:

Cel:

Fax:

Physical Address

Street:

Suburb:

City / Town:

Post Code:

Country:

Postal Address / P.O. Box:

Suburb:

City / Town:

Post Code:

Country:

ITIL Practitioner:

ITIL Foundation:

ITIL Service Manager:

If you are applying for an Individual Membership, please scroll down to the Payment Details section in order to process your online payment.

If you are applying for a Vendor or a Corporate Membership please complete Section 2

__________________________________________________________________________

Section 2 - Company Details

Registered Companies List (Select if Applicable - NB: Not in Alphabetical Order):

Company Trading Name (If Not Listed Above):

Registered Name:

Business Type:

Public Company	Partnership
(PTY) LTD	Sole Proprietor
CC	Other

Registration #:

Vat # (If applicable):

Primary Member Details

The details of the Primary member of your company in charge of administration of its itsmfsa members

Name:

Tel:

Cell:

Email:

Fax:

Accounting Contact Details

The details of the person in charge of your company accounts.

Name:

Tel:

Cell:

Fax:

Email:

Purchase Order / Reference:

Company Address and Postal Information

Physical Address:

Suburb:

City / Town:

Post Code:

Country:

Postal Address / P.O. Box:

Suburb:

City / Town:

Post Code:

Country:

Pease make your payments to our bank account below. In order to facilitate identification of your payment, kindly use your name or your company name as a payment reference so we can match your payment.
Membership will only be activated after payment is received.
Bank: ABSA Bank
Branch: Rosebank
Branch Code: 632-005
Account Nr: 4049213862
SWIFT Code for International Transfers: ABSAZAJJ

PLEASE FAX THE PROOF OF PAYMENT TO: +27 (11) 252 5471

Should you require an invoice prior to making the payment, kindly click here to email us your request

All memberships will receive an official VAT invoice on completion and payment of registration

Note: It is important to remember to allow 3-5 business days for your membership to be processed and activated after payment is received.

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