Register as a Service Provider FABASA Supplier Application Form Name of Supplier: Name of Key Contact Person: Contact details: Office: Fax: Cellular: Email: Address: Service category: Accounting Technology Marketing Services Consulting Legal BBBEE Other: Brief Summary of Services to be supplied (maximum 100 words): Motivation for Membership to FABASA (maximum 150 words): Value Offering to FABASA members: List of Fees / Charges: