NAMA Regional Service Provider
Membership Application

NAMA Regional Service Providers are recognized by the Association as members who have demonstrated an acceptable level of competency and ethical standing in the industry. The Regional Service Provider is in no way involved in community scheme management.

Company Details

Registered Business Name *

Trade Name of Business *

Company Registration Number *

Upload CIPC Document *

Company VAT Number

Upload VAT Registration Confirmation

Debt Collectors Registration

Upload Debt Collectors Registration Document (if applicable)

FSP Registration Number

Upload FSP Registration Document (if applicable)

Registration with Industry Body (e.g., Security registered with PSiRA)

Upload Industry Body Registration Document (if applicable)

Website / Social Media Address

Company Logo (PNG/JPEG only)

About Your Company (max 1000 characters)

Upload Completed NAMA Debit Order Form Download NAMA Debit Order Form

Upload Signed NAMA Terms and Conditions * Download NAMA Terms and Conditions

Upload Signed NAMA MOI * Download NAMA MOI

Upload Signed NAMA Code of Conduct Download NAMA Code of Conduct

Contact Details

Please complete details for Directors/Owners and Company Contact Persons.

Number of Directors/Owners *

Number of Company Contact Persons *

Accounts Department Details

Name *

Surname *

Email Address *

Office Contact Number *

Payment and Cost

Annual Fee = R9500,00 (Including VAT)
Monthly via NAMA Debit Order = R800,00 (Including VAT)
I agree to receive financial information electronically.

Upload Debit Order Form (PDF only, if applicable)

Address Details

Physical Address

Street Address 1 *

Street Address 2

Suburb *

City *

Province *

Postal Code

Postal Address

Postal Address same as Physical Address

Postal Address 1

Postal Address 2

Suburb

City

Province

Postal Code

Documents to Accompany your Application

Company Logo
CIPC Document
VAT Registration Document
FSP Registration Document
Debt Collectors Registration Document
Industry Body Registration Document
Debit Order Form

Acceptance of NAMA Documents

NAMA Terms and Conditions Download
NAMA MOI Download

Preferred NAMA Region

Gauteng North – North of the Jukskei River, Pretoria, Limpopo, Mpumalanga and Northern North-West Province
Gauteng South – South of the Jukskei, Johannesburg Area
Western Cape & Northern Cape
KwaZulu-Natal
Free State
Eastern Cape & Border

Completed By

Name *

Surname *

Designation *

Email Address *

Contact Number *

Date *

NAMA Regional Service Provider
Membership Application

Company Details

Contact Details

Accounts Department Details

Payment and Cost

Address Details

Documents to Accompany your Application

Acceptance of NAMA Documents

Preferred NAMA Region

Completed By

Explore

Contact us

Links to Stakeholders

Links to NAMA National Service Providers

NAMA Regional Service ProviderMembership Application

Company Details

Contact Details

Accounts Department Details

Payment and Cost

Address Details

Documents to Accompany your Application

Acceptance of NAMA Documents

Preferred NAMA Region

Completed By

Explore

Contact us

Links to Stakeholders

Links to NAMA National Service Providers

NAMA Regional Service Provider
Membership Application