Become a member

Sign-Up Form

Step 1. Pay your membership fee for 2018, and send the POP to webmaster@dermatology.co.za

Step 2. Complete the electronic membership registration to receive via email your unique membership number and Log In details.

Complete the form below to register:

First name *

Last name *

Title *

Member Type *

Your email address *

Choose a password *

Confirm password *

Tel (H)

Tel (W)

Mobile *

Address *

City / Town *

Country *

Your HPCSA number *

Special Interests

What topics would you like covered in the future?

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