HENTIES BAY TOURISM ASSOCIATION
POSTAL ADDRESS:  P.O. BOX 595, HENTIES BAY

 APPLICATION FOR MEMBERSHIP FOR THE PERIOD 1 MARCH 2011 TO 28 FEBRUARY 2012:  BUSINESS

 NAME AND NTB REGISTRATION NO (where applicable)
1^ST BUSINESS:                                                                                      NTB                     
2^ND BUSINESS:                                                                                     NTB                    
3^RD BUSINESS:                                                                                     NTB                    

 NAME OF OWNER/MANAGING DIRECTOR ....................................................

POSTAL ADDRESS
.....................................................................................
.....................................................................................
.....................................................................................

PHYSICAL ADDRESS/FISIESE ADRES
.....................................................................................
.....................................................................................
....................................................................................

TELEPHONE NUMBER:                                                                     
FAX NUMBER:                                                                                   
E-MAIL ADDRESS                                                             
WEBSITE ADDRESS                                                                          

ATTACHED PLEASE FIND MY CHEQUE/CASH FOR                                       N$                     

1^ST BUSINESS:                                                                                                   N$ 350.00       
2^ND BUSINESS:                                                                                                  N$  300.00      
3^RD BUSINESS:                                                                                                  N$  250.00      
4th BUSINESS:                                                                                                   N$  200.00     
5 AND MORE:                                                                                                      N$  1250.00   

I HEREBY AGREE TO BE BOUND BY THE ASSOCIATION’S CONSTITUTION AND ALL AMENDMENTS THERETO

SIGNED AT    ..........................................  ON THE .......  DAY OF ............................... 2011

SIGNATURE                                                                                                            

BANK DETAILS: 
BANK WINDHOEK
SWAKOPMUND BRANCH: 481-772
ACCOUNT NO: 8000 252 384