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SAMSU MEMBERSHIP FORM
I To: All Medical Students

While we are in the process of developing the SAMSU Customer Relationship Management (CRM) system, we have temporarily set up this form to be used for recruitment. Kindly complete your details below to become a SAMSU member. The information collected here will be imported onto the CRM once its development is completed, meaning that if you have completed your details on this form, you will not have to reapply once the CRM is functional.
Name
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Surname
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Gender M
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Female
Male
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Contact Number
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Correct answers: Correct Answer, Correct Answer
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Email Address 
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University 
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University of Cape Town
University of the Free State
University of KwaZulu-Natal
University of Limpopo
Stellenbosch University
University of the Witwatersrand
Walter Sisulu University
Nelson Mandela University
Sefako Makgatho Health Sciences University
University of Pretoria
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Year of study6
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1
2
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3
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6
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ID Number
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Option 1
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