login
The South African Multiple Birth Association

  Member Login
Help 
username
  
password
  
nav
register as member or renew membership

Step 1: Make online payment.
Membership fees
Price
 Banking Details
(You will need to upload the proof of payment with registration)
RSA
R180.00
 SAMBA National
Nedbank
Account: 1522014624
Code:Epsom Downs (152205)
Ref: Your Surname
Step 2:

 Complete the Registration form below.
Outside RSA
R200.00


registration form

SAMBA - The South African Multiple Birth Association
Membership

if yes, supply membership no
Membership no:
Membership expiry:
Surname:
Tel Home:
Expecting (twins/trip):
new registration
Email Address:
Due Date:
new registration
Marital Status
Mother
Father
First Name
First Name:
ID Number:
ID Number:
Date of Birth:
Date of Birth:
Cell:
Cell:
Work:
Work:
Occupation:
Occupation:
Company:
Company:
Postal Address:
Physical Address:

Children
Names:
Singleton/ Twin/ Trip:
Identical/ Fraternal:
Gender:
Birth date:
Hospital:
Fertiliy Drugs?
Drug Type:
Do you have multiples in your family?
Please specify:
Are you willing to help on SAMBA committee?
Please specify:
If you have a special needs child or a child with disabilities, would you like to be contacted?
Please specify:
Would you like multiples listed for Ad Agencies for adverts?
Where did you hear about SAMBA?
Membership fees
Price
RSA
R180.00
Outside RSA
R200.00
Image verification:

> Next step: Upload proof of payment


nav
SAMBA: The South African
Multiple Birth Association

Phone: 082 602 1828