New Member Registration FormPlease DO NOT use this form for the RENEWAL of existing membership

Please note – all fields are required (must be filled in) unless otherwise indicated.
Please hover over the ? (question mark) to read more about what to enter in the field.

  Personal Information  
?
  Contact Details  
  Address Details  
?
?
  Professional  
?
?
  Intern Supervision  
  Membership Requirements, Malpractice Insurance and Payment Method  
?
?
?
  Online Demographics  
  1. What equipment do you personally use when surfing WEB SITES? (Select all that apply)    Desktop or Laptop Computer 
Apple iOS System
 Tablet - with a Touch screen which is at least 6" WIDE or more 
iPad Tablet
Android Tablet
MS Windows Tablet
 Smartphones or mobiles - screen smaller than 5" wide 
iPhone
Blackberry
Android e.g. Samsung, HTC, Motorola
Windows phone
  2. What type of Internet Connection do you PRIMARILY use?  
  3. When are you able to access the internet to surf WEB SITES?  
  4. Do you have to share a computer to access the BASA website?  
  5. Do you use your CELLPHONE to read and manage your emails?  
  6. What time of the day do you USUALLY read your PERSONAL emails e.g. Newsletters from BASA?  
  7. Which browser do you primarily use when surfing websites?  
  8. How often do you use the following social media networks?  
Social Media Daily Weekly Never
Facebook
Twitter
Google+
LinkedIn
Other
  9. Tell us what you think?  
  Terms and Conditions  

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2013 © Biokinetics Association of South Africa - All Rights Reserved
P O Box 12448, Clubview 0014, Pretoria
Gauteng, South Africa

Registration: 107-094-NPO
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