MEMBERSHIP APPLICATION FORM

Please fill in the form below. Alternatively you may download the application form here. Please send your completed application form to info@agda.org.za.

Name of organisation *

VAT Number

Email *

Confirm Email

Address *

Province *

Telephone Number *

District *

Name of contact person *

Year of first AGDA membership *

Other type of organisation

Province(s) operating in *

District(s) operating in *

PLEASE TICK THE BOXES BELOW TO INDICATE YOUR AGREEMENT WITH THESE BASIC TERMS OF ENGAGEMENT: *

I understand that by providing the information above I agree to AGDA using the provided information in their operations, and that such information will be utilised in line with the South African Protection of Personal Information Act (POPI Act).

PLEASE TICK THE BOXES BELOW TO INDICATE YOUR AGREEMENT WITH THESE BASIC TERMS OF ENGAGEMENT: *

I agree to and hereby give permission for AGDA to generate, utilise and store any audio-visual or other materials or footage including my organisation that may be applicable to the operations and functionality of AGDA.

Association members (Co-ops, Commodity Organisations, Agri-organisations, etc)

Level 1 - More than 1000 members - R25 000
Level 2 - Between 500 and 999 members - R12 500
Level 3 - Less than 500 members - R6 250

If you are a farmer, which category to you represent - Small/Medium/Large

What commodities do you specialise in?

Do you have access to markets?

Any other information that you think may be helpful

Any other information that you think may be useful

If you are part of another sector, which sector do you represent eg. Financial services, Legal, Construction etc.

Nature and type of business

Any other information that you think may be useful