Member Registration - Step 2

Step 2

Account Information

First Name*

Last Name*

Email Address*

Phone Number*

Date of Birth*

ID Number*

LinkedIn profile

Add your LinkedIn Profile URL (optional)

Home Address

Address Line 1*

Address Line 2*

Town / City*

Province*

Country

Postal Code

Use the same address as Postal Address

Postal Address

Address Line 1*

Address Line 2*

Town / City*

Province*

Country

Postal Code

Professional Details

Current Occupation*

Current Company Name*

Why would you like to join SAFHE?*

Education, Training and Professional Qualifications

Qualification/Training Name

Year of Completion

Write an overview about your education and career in relation to the healthcare sector and the SAFHE values. Please note, this information will be used in your profile that other members will see if your application is approved. You will be able to update this information in your member portal.*

Upload a copy of your CV (only PDF files accepted)

Upload a profile photo*

Please note that this image will be used in your member profile.

Drag & drop images here or click to select

PLEASE NOTE:
After approval of admission, membership will be granted subject to payment of the entrance fee and annual subscription.

I accept all terms & conditions and privacy policies

Member Application

Account Information

Drag & drop images here or click to select

Quick Links

Contact Us