Certification Agreement Application Form CERTIFICATION-AGREEMENT-BETWEEN-THE-PROFESSIONAL-GOLFERS-ASSOCIATION-OF-SOUTH-AFRICA-AND-THE-APPLICANT Applicant Name * Applicant’s Identity/Passport Number * Contact Name * Title * Facsimile Number (if applicable) DOMICILIUM FOR THE PURPOSES OF CLAUSE 11.1.2 Applicant Physical Work Address * Applicant Postal Address * Mobile Number * Telephone Number (Landline of Practice) * Email * AUDIT INFORMATION Body of which Applicant is a Member * —Please choose an option—Professional Golfers Association of South AfricaChiropractic Association of South AfricaPhysiotherapy Association of South AfricaBiokinetics Association of South Africa Member Number * Years in Practice * Upload copy of ID Upload Qualification Certificate Upload Current Proof of Membership Terms & conditions of the CERTIFICATION AGREEMENT (Download) I accept the Terms & conditions of the CERTIFICATION AGREEMENT Δ