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WMRIG Member Application Form
WMRIG is an Interest Group within the Western Cape Branch of IWMSA

Please complete all the fields before submitting the form

Applicant Details
Title
First Name *
Your answer
Surname *
Your answer
Company represented *
Your answer
Telephone
Your answer
Mobile / Cell *
Your answer
e-Mail *
Your answer
Postal Address *
Your answer
Date of application
MM
/
DD
/
YYYY
Have you been or are you a WMRIG committee member?
If yes, indicate period(s)
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