Entity Category Application - FIRA - Funeral Industry Reformed Association

Home
About
Blog
Members
Resources
Contact Us

Request Consultation

Home
About
Blog
Members
Resources
Contact Us

info@fira.org.za
+27 (0)12 007 3061

Home Entity Category Application

Entity Category Application

Entity Categories Application Form

Step 1 of 4

25%

Account Details
Email*
Password
Enter Password Confirm Password
User Details
Name*
Title First Last
Cell*
Home Tel

Company Details
Company Name*
Business Type*
- Administrator
- Banking Industry
- Broker
- Burial Society
- Distributor
- Faith Based Group
- Insurance Company
- Legal Representative
- Manufacturer
- NGO
- Service Provider
- Supplier
- Union
Owners*
Physical Address*
Street Address Address Line 2 City Province Postal Code
Physical Address*
Same as previous

Street Address Address Line 2 City Province Postal Code
Head Office Address
Same as previous

Street Address Address Line 2 City Province Postal Code
Work Tel
Fax
Website
Number of Branches
Operating Provinces
- Gauteng
- Northern Cape
- Western Cape
- Eastern Cape
- Free State
- North West
- Limpopo
- Mpumalanga
- KwaZulu Natal

Nature of Business
Insurance Marketing
- Do you market funeral insurance or membership for a funeral scheme?
Do you supply goods and services within the funeral & related services industries?*
- Yes
- No
What is the nature of the goods and/or services rendered?*
Copy of the registration certificate of the entity*
Accepted file types: jpg, png, pdf.

Agreement and Confirmation
Signature*
Agreement*
I agree to the constitution and membership policy
Consent*
I agree to the membership application policy*
My application shall be dealt with according to the rules and terms and
conditions of FIRA, the information provided by me herein is, to the best of my knowledge, true and correct
and to undertake to the following:
 I confirm my authority to apply herewith on behalf of the above-mentioned company;
 I accept the FIRA's Code of Conduct as the basis on which the company will be operated;
 I will strive to uphold the Constitution of the FIRA;
 Where applicable I will meet the minimum requirements concerning the funeral directing profession
including health requirements;
 I undertake to pay the annual membership fees as determined during the Annual General Meetings.
Payment Terms*
I agree that membership would commence on proof of payment.
I understand that in the case of the application being unsuccessful, the application fee will be forfeited.*
Payment of R4,800.00 payable immediately. On acceptance of your application, the balance of the annual membership fee, which is R20,000.00 per annum, will be payable.
Payment to be made to the following account:

Bank: Standard Bank
Account Number: 012710202
Account Name: FIRA
Account Type: Business Current
Branch Code: 051001
Reference: Your Company Name
Send Proof of Payment to: info@fira.org.za
Payment Terms*
I agree that membership would commence on proof of payment.
I understand that in the case of the application being unsuccessful, the application fee will be forfeited.*
Payment of R16,600.00 payable immediately. On acceptance of your application, the balance of the annual membership fee, which is R50,000.00 per annum, will be payable.
Payment to be made to the following account:

Bank: Standard Bank
Account Number: 012710202
Account Name: FIRA
Account Type: Business Current
Branch Code: 051001
Reference: Your Company Name
Send Proof of Payment to: info@fira.org.za
Payment Terms*
I agree that membership would commence on proof of payment.
I understand that in the case of the application being unsuccessful, the application fee will be forfeited.*
Payment of R3,300.00 payable immediately. On acceptance of your application, the balance of the annual membership fee, which is R10,000.00 per annum, will be payable.
Payment to be made to the following account:

Bank: Standard Bank
Account Number: 012710202
Account Name: FIRA
Account Type: Business Current
Branch Code: 051001
Reference: Your Company Name
Send Proof of Payment to: info@fira.org.za
Payment Terms*
I agree that membership would commence on proof of payment.
I understand that in the case of the application being unsuccessful, the application fee will be forfeited.*
Payment of R10,000.00 payable immediately. On acceptance of your application, the balance of the annual membership fee, which is R30,000.00 per annum, will be payable.
Payment to be made to the following account:

Bank: Standard Bank
Account Number: 012710202
Account Name: FIRA
Account Type: Business Current
Branch Code: 051001
Reference: Your Company Name
Send Proof of Payment to: info@fira.org.za
Payment Terms*
I agree that membership would commence on proof of payment.
I understand that in the case of the application being unsuccessful, the application fee will be forfeited.*
Payment of R600.00 payable immediately. On acceptance of your application, the balance of the annual membership fee, which is R6,000.00 per annum, will be payable.
Payment to be made to the following account:

Bank: Standard Bank
Account Number: 012710202
Account Name: FIRA
Account Type: Business Current
Branch Code: 051001
Reference: Your Company Name
Send Proof of Payment to: info@fira.org.za
Payment Terms*
I agree that membership would commence on proof of payment.
I understand that in the case of the application being unsuccessful, the application fee will be forfeited.*
Payment of R600.00 payable immediately. On acceptance of your application, the balance of the annual membership fee, which is R3,800.00 per annum, will be payable.
Payment to be made to the following account:

Bank: Standard Bank
Account Number: 012710202
Account Name: FIRA
Account Type: Business Current
Branch Code: 051001
Reference: Your Company Name
Send Proof of Payment to: info@fira.org.za
Name
This field is for validation purposes and should be left unchanged.

FIRA – Funeral Industry Reformed Association

Please leave this field empty

Sign up to receive our latest news in your inbox.

We don’t spam! Read our privacy policy for more info.

Check your inbox or spam folder to confirm your subscription.

Our Contact

info@fira.org.za | johanr@fira.org.za
+27 (0)12 007 3061
+27 (0)72 852 5456
+27 (0)76 895 2784

© Copyright All Rights Reserved by Kuberkon