Membership Application Application Form Membership Fee R600 Payment can be made directly into the SAFSA account: Account name: SAFSABank: Standard Bank of South AfricaBranch: Lynnwood RidgeBranch code: 012 445Account number: 014 307 936 Please complete the registration form and send proof of payment to: zeta@footsurgery.co.za Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastTitle *Hospital *Postal Address *Physical Business Address *Telephone Number *Cellphone Number *Email Address *Additional MessageSubmit