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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:

Please leave this field empty.