APPLICATION FORM

MIC 1a
MEMBERSHIP

Title Initials
Please enter your first and last names below as they appear in your identification document or passport.
First Name/s Surname

Postal address
Postal code

Residential address
Postal code
Email address
Work number Home number
Fax number Mobile number
Date of Birth Gender
Citizenship
ID or passport number
Race (for stats purposes) African Asian Coloured Indian White
If none of the above, please provide details
Driver’s licence Yes No If yes, licence code

If RSA permanent resident, please indicate date obtained

In possession of a Study Permit? (If yes, please provide a copy of
your current permit with your application)
Social Media Accounts

Do you have a disability?

If Yes, indicate nature of disability

Have you ever been deployed at

Yes No If yes, dates of deployment?
SASTU?
If yes above, previous department?
If yes, what was the position you occupied? Yes No

University
Campus
Student No
Qualification
Are you currently registered as a student? Yes No
If no, please specify your current activity
DECLARATIONS
I the undersigned applicant for membership of SASTU, solemnly declare that I will abide by the aims and objectives of the South African Student
Teachers Union as set out in the By-Law Document, and other duly adopted policy positions, that I am joining the organisation voluntarily and without bad motives of any
manner or personal gain, that I agree to respect the By-Law Document and the structures and to work as a loyal member of the organisation, that I will place my energies
and skills at the disposal of the organisation and carry out tasks given to me, that I will work towards making SASTU an even more effective instrument of liberation in the
hands of the student teachers, and that I will defend the unity and integrity of the organisation and its principles, and combat any tendency towards disruption and
factionalism, I am aware that SASTU is converting to SADTU Student Chapter.

Name Date
Signature (Put Your Initial, Surname If Filling Online)
OFFICE USE ONLY
Branch Code Membership No
Province
Membership Approved or Not Approved Comment: Yes No

Official Date
Signature (Put Your Initial, Surname If Filling Online)

SASTU 2017