Please complete the required fields below before submitting your application form to SASQ. Note that some fields are mandatory and if they are not completed the form will not submit.


QualityEnvironmentalHealth & SafetySHEQ

Your Details

Title (Required)

First Names (Required)

Surname (Required)


Citizenship (Required)

ID Number (Required

Job Title (Required)

E-mail address (Required)

My position relates to the practice of:

QualityEnvironmentalSafetyHealthHealth & SafetySHEQConsultant

Company Information:

Company Name (Required)

Company Address Line 1 (Required)

Company Address Line 2

City (Required)

Province (Required)

Post Code (Required)

Business Telephone (Required)

Mobile Phone (Required)

Business Fax

Business E-mail (Required)

Economic Sector (Required)

Type of Business (Required)

Company Registration No. (Required)

Vat Number

Other details

Home Address - Street Name (Required)

Building / Centre (Required)

City (Required)

Province (Required)

Post Code (Required)

Home Telephone(Required)

How were you referred to the SASQ?

FriendColleagueSASQ MeetingSASQ MemberConference / SeminarWebsiteGoogleYahooBingOther Search EngineOther BlogArticle

Is your company a member of SASQ? YesNoDon't Know

Do you want a letter sent to your organisation recognising your membership to SASQ? YesNo

If yes, please supply details of receiving person and email address

Recipient's Name

Recipients E-mail

Do you want your details to be inserted on the SASQ website? (Required)YesNo

Preferred area to attend SASQ events (Required)

Other venue if selected above

I am an active member in the following fields
Call CentreCorporate Social Responsibility (ISO 26000)Course ProviderEnergy Management (IS0 51000)Food SafetyHealth CareLaboratoryMilitary & SecurityProject QualityResearchRisk Management (ISO 31000)School QualityService QualitySupply ChainSystems AuditingOther

Other field if selected above

Current Employment / Position

Employed from (Required)
Name of Organization (Required)
Job Title (Required)
Nature of work (Required)

Briefly motivate why you wish to join SASQ (Required)

Membership of other professional institutions:

Institution 1
Year elected

Institution 2
Year elected

Institution 3
Year elected

Upload the following documents with this application.
Upload your detailed CV here:
Upload your ID document here:
Upload supporting letter from employer:

I certify that the information submitted in this application is complete and correct to the best of my knowledge and belief. I understand that, if the information I have submitted is found to be incomplete or inaccurate, my application may be rejected or membership revoked. I am also aware of all the SASQ benefits offered to me as an associate member.

I agree to comply with the SASQ code of ethics. The SASQ Code of Ethics is available at: Read SASQ's Code of Ethics

After you submit your application, SASQ will send you an e-mail with instructions on how to proceed.