PLEASE SELECT THIS FORM,PASTE ON MICROSOFT WORD, PRINT AND FILL. Membership Form: 2009-2010 R50 per annum   Date of Registration: _____________                                                                      Surname: ___________________________ First Name: _______________________________________   ID No: ___________________________   Next of kin ____________________________   cell no._________________   E-mail address: __________________________________ Date of Birth: ___________________________  Home Address: ______________________________________________________________________________ Postal address: ___________________________________________________________________________ City & Postal Code: ____________________________________   Telephone Number (#) at Home: ____________________ Mobile Phone #: ____________________________ Office Phone #:_______________________ Home Language: _________________________________________ Other languages you speak/understand: __________________________________________________       ______________________________________________________________________________________________________________________________________                             Signature                                                                                                            Date   Please return to:    Prof L. Makalela Rural English Teachers Association Private bag X1106 SOVENGA 0727                                                                       e-mail:    johnm@ul.ac.za         FAX: 015 268 3299   All payments should   First National Bank Account name: RETA Account no: 6282950925   Send you receipt to: the Treasure Rural English Teachers Association P.O Box 822 Lebowakgomo 0737