HSBA Membership Application Form

Membership (New) From $88.00

Please select one of the membership types

Individual (1 year) $230.00

Individual (2 years) $400.00

Individual (3 years) $500.00

Institutional (1 year) $350.00

Institutional (2 years) $600.00

Institutional (3 years) $800.00

Young Professional Alliance (YPA) (1 year) $88.00

Total Amount

Amount Due

Salutation *

Mr

Mrs

Ms

Dr

Prof

First Name *

Last Name *

Company Name *

Designation *

Address *

Company Website *

Nature of Business *

Nature of your business / occupation? *

How long have you been in this business / company? *

Office Tel *

Mobile Number *

Date of Birth *

Email *

Recommended By *

Recommender's email

Would you like to receive updates about our other events? *

Please review your response before submitting it for processing.

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