Member Registration Form Step 1 of 5 20% COALTECH RESEARCH ASSOCIATIONSelect Type of Membership(Required)AssociatesIndividualsMiners Less Than 4MTPAMiners Greater Than 4MTPA Individual InformationName and Surname(Required) Company Street Address(Required) Postal Address (If Different) Email(Required) Telephone Number(Required) Company InformationCompany Name(Required) Company Registration Number Company Street Address(Required) Postal Address (If Different) Website URL Company’s Main Business(Required) Contact Person DetailsContact Person Name(Required) Contact Email(Required) Contact Telephone Number(Required) Membership Details Membership Options - Select the option(s) for your Company:Individual Member Individual Membership Fee R1,500 ex VAT PA Research Focus Areas Mining/Engineering Coal Processing Surface Environment Future Technologies * Fee R20,000 ex VAT PAResearch Focus Areas Mining/Engineering Coal Processing Surface Environment Future Technologies Research Focus Areas Mining/Engineering Coal Processing Surface Environment Future Technologies * Fee R30,000 ex VAT PAResearch Focus Areas Mining/Engineering Coal Processing Surface Environment Future Technologies * Fee R50,000 ex VAT PABoard Member (Optional) Board Membership Fee R500,000 ex VAT PA * Board Membership is inclusive of participation across all Research Focus areas. Representative Coaltech representative & Alternative representativeName(Required) Coaltech representative (Person that will represent the Company) Email(Required) Contact Number(Required)Alternative RepresentativeName Alternate representative (Alternate that will stand-in for representative): Email Contact NumberEmailThis field is for validation purposes and should be left unchanged.
