FOM 2019 MEMBERSHIP REGISTRATION & RENEWAL FORM
FOM is a registered Public Benefit Organisation 930055453
MEMBERS’ CONFIDENTIAL INFORMATION
The (*) indicates required information
First Name *
Your answer
Last Name *
Your answer
Email address *
Your answer
Address *
Your answer
Telephone
Your answer
Mobile
Your answer
Would you like to be an active member and help with our events?
How did you hear about FOM? *
Your answer
Type of Membership *
How Many Memberships are you buying? *
Your answer
DONATIONS
Donations over R99 qualify for a SECTION 18A Tax Exemption Certificate
Donation Amount
Your answer
PLEASE CONFIRM TOTAL AMOUNT
(Your membership amount plus your donation)
TOTAL AMOUNT *
Your answer
BANKING DETAILS: Please use Your Name as the beneficiary reference for your payment, so that we can allocate your payment to your membership.

Proof of payment via email: mrusso@mweb.co.za
(FOM Treasurer Stephen Russo)

Thank you!

EFT Details
Standard Bank, Rondebosch
Branch: 025009
Account Name: Friends of Orchestral Music
Account No: 071 03 1146
Beneficiary Reference: Your Name
SWIFT Code: SBZAZAJJ

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