MEM-F: 01 Rev 7

MEMBERSHIP APPLICATION FORM November 2020

MEMBERSHIP APPLICATION FORM

IMPORTANT – Read First:

1. Please print this document and complete it in full.

2. This application form must be completed as carefully, accurately and comprehensively as
possible. Please sign where indicated.
3. Please supply supporting documentation, as specified in the application form, for verification
purposes. This will ensure a speedy and successful approval process.
4. Applications without sufficient supporting documentation or evidence will be referred back to
the applicant to provide such information before membership is considered.
5. Please note that the information is required in order to protect the credibility of the Proudly
South African Brand / logo and to ensure compliance with the 4 criteria of the buy local
campaign.

PLEASE POST, FAX, E-MAIL OR DELIVER THIS FORM, WITH THE NECESSARY SUPPORTING
DOCUMENTATION, TO THE PROUDLY SOUTH AFRICAN
MEMBERSHIP DEPARTMENT

Physical: 23 Sturdee Avenue, Rosebank, 2196

Postal: PO Box 1062, Saxonwold, 2132

Telephone: (011) 327-7778
Fax: (011) 327-7459

E-mail: [email protected]

Website: www.proudlysa.co.za

ISO 9001: 2015 QUALITY MANAGEMENT SYSTEM

©This Document is the property of PROUDLY SOUTH AFRICAN and may not be copied or distributed to any third party without the express permission of the CEO in consultation with the MRQ
 MEM-F: 01 Rev 7
MEMBERSHIP APPLICATION FORM November 2020

STAND OUT FROM THE CROWD - BECOME A PROUDLY SOUTH AFRICAN MEMBER

Business/Organisation Name

Trading Name

Company Registration Number

Vat Registration Number

❑ (Pty) Ltd ❑ Close Corporation ❑ Sole Proprietorship ❑ Partnership ❑ Cooperatives ❑ NGO/NPO ❑ Other

Postal address

Physical address

Company Profile

Sector (refer to schedule B on pg 6)

Primary Contact

Title (circle one) Mr / Mrs / Ms / Dr / Prof / Other (Specify)

Surname First Name Designation

Telephone ( ) Fax ( )

Cell phone Email address Website

Secondary Contact

Surname First Name Designation

Telephone ( ) Fax ( )

Cell phone Email address Website

SECTION 1: COMPLIANCE WITH MEMBERSHIP CRITERIA

To ensure that the Proudly South African symbol represents high standard of quality, as well as identifying only products and
services which contribute positively to the economy, please confirm adherence to the following four qualifying criteria:

1. Local content 2. Quality 3. Fair Labour 4. Environment

Is at least 50% of the cost Does your product or Are you committed to Are you committed to
of production of your service meet high quality fair labour practices and sound environmental
products/services incurred standards? to continually improving practices and to
in South Africa (including your labour relations? continually improving
raw materials, labour, your contribution to the
logistics and marketing)? environment?

ISO 9001: 2015 QUALITY MANAGEMENT SYSTEM

©This Document is the property of PROUDLY SOUTH AFRICAN and may not be copied or distributed to any third party without the express permission of the CEO in consultation with the MRQ
 MEM-F: 01 Rev 7
MEMBERSHIP APPLICATION FORM November 2020

To safeguard the integrity of the Proudly South African campaign and symbol, you need to substantiate adherence to the above
standards. This could take the form of a local content breakdown, customer testimonials, quality management policy,
membership of industry associations, SABS approval, audited financial statements, company profile, letter of undertaking from
CEO, environmental management policies, labour policies etc. depending on the sector in which you operate. Please contact a
membership consultant should you have any queries in this regard.

SECTION 1.1: LOCAL CONTENT

ITEM OF CONTENT NAME OF ITEM SUPPLIER LOCALLY % OF LOCAL % OF IMPORTED

BASED ITEM ITEM
Yes No

Logistics/Distribution

Marketing/Advertising

Equipment/Furniture

Other

Bill of Material/Raw
Material
Number of employees Do you % of % of staff
employ staff based
outside the based outside
Labour borders of in RSA
RSA? RSA
Full-time Part-time Yes No

*Attach additional Bill of material on a separate sheet.

SECTION 2: CALCULATING YOUR MEMBERSHIP FEE

Please Note: 1. All fees are based on the fee structure determined by Proudly South African.

2. You will be invoiced in full, for your annual membership, once your application has been approved.

3. Your membership will only be confirmed once payment is received.

4. Members qualify for a discounted annual fee when opting for a two (2) or three (3) year membership for
those companies turning over R50 million or more per annum.

ISO 9001: 2015 QUALITY MANAGEMENT SYSTEM

©This Document is the property of PROUDLY SOUTH AFRICAN and may not be copied or distributed to any third party without the express permission of the CEO in consultation with the MRQ
 MEM-F: 01 Rev 7
MEMBERSHIP APPLICATION FORM November 2020

SECTION 3: COMPANY CLASSIFICATION

Company turnover*: (tick the relevant box)

❑ R 0 - <R 5 m ❑ R 5m - <R10m ❑ R 10m – <R30m ❑ R 30m -<50m ❑ R50m-<R100m ❑ over R100m

SECTION 4: PRODUCT AND SERVICE INFORMATION

The information in this section ensures that Proudly South African keeps track of the authorised use of its logo - and can
develop suitable promotions for members.

All information provided in this section will be uploaded onto our database for usage on the website’s search facility.

PRODUCTS:
1. If you manufacture / fabricate physical products which will carry the Proudly South African logo, you shall list each
one here. Please include a complete list of products/services, including details of all variants and pack sizes. IF THE
LIST IS TOO LARGE TO FIT ON THIS SHEET, ATTACH IT SEPARATELY TO THIS APPLLICATION .
2. For services/products to qualify for endorsement with the Proudly South African logo, a minimum of 50% of the cost
of those products must be made up of materials, components and labour of South African origin.
3. DO NOT LIST IMPORTED PRODUCTS – THEY MAY NOT CARRY THE PROUDLY SOUTH AFRICAN LOGO.
SERVICES:
1. If you provide services/products which will be endorsed with the Proudly South African logo, you shall list each here.
IF THE LIST IS TOO LARGE TO FIT ON THIS PAGE, PLEASE ATTACH IT SEPARATELY TO THIS
APPLICATION.

PRODUCT / SERVICE NAME PRODUCT / SERVICE DESCRIPTION

ISO 9001: 2015 QUALITY MANAGEMENT SYSTEM

©This Document is the property of PROUDLY SOUTH AFRICAN and may not be copied or distributed to any third party without the express permission of the CEO in consultation with the MRQ
 MEM-F: 01 Rev 7
MEMBERSHIP APPLICATION FORM November 2020
SCHEDULE A: TERMS AND CONDITIONS OF MEMBERSHIP

By signing this application form, the management of the applicant organisation commits and agrees to all of the terms
and conditions of Proudly South African membership listed on this page.

1. MANAGEMENT COMMITMENT
Management and staff of the applicant organisation will, at all times:
a) Support the aims and objectives of the Proudly South African campaign.
b) Obtain prior approval from Proudly South African for any use of the Proudly South African logo. (Not specified in this application)
c) Abide by the terms and conditions.
d) Whenever possible, increase the level of local content in the applicant organisation’s product and / or business activities.
e) Practice fair and responsible standards including compliance with all labour legislation.
f) Maintain and improve the quality of the applicant organisation’s activities, products and services.
g) Practice sensible environmental behaviour.
h) Help to promote the Proudly South African campaign to the applicant organisation’s staff, customers, suppliers and
stakeholders.

2. PROCUREMENT COMMITMENT
Management and staff of the applicant organisation will, at all times:

a) Give first preference to other Proudly South African companies when purchasing goods, materials and services required for
the applicant organisation’s activities.
b) Notify other Proudly South African members of such supply opportunities when they arise.
c) Wherever possible, purchase the materials, goods and services required for the applicant organisation’s activities from
companies or suppliers operating in South Africa who use materials made in South Africa and labour within the border of South
Africa.
d) Ensure that the applicant organisation’s buying and procurement policies and decisions reflect the applicant organisation’s
commitment to the Proudly South African campaign.

3. FURNISHING OF INFORMATION
Management of the applicant company agrees to furnish additional information, as may be required by the Proudly South African
organisation, in order for Proudly South African to satisfy itself that the applicant organisation qualifies for membership. While
Proudly South African recognises the applicant organisation’s rights to withhold information it deems sensitive or private, failure
to supply information requested by Proudly South African may disqualify the applicant organisation from obtaining Proudly South
African membership. Proudly South African’s decision in this regard will be final.

4. COMPLIANCE CHECKING
Both before and after membership has been granted, Proudly South African may conduct certain compliance checks on member
organisations. The management of the applicant organisation agrees to provide full co-operation to Proudly South African or its
representatives, during the process and compliancy checks.

5. MEMBERSHIP SUBSCRIPTION PAYMENT

Following a successful application, your organisation will be invoiced for the annual membership fee. Final membership will only
be granted once payment has been received.

6. CANCELLATION
a) Proudly South African reserves the right to cancel any member organisation’s subscription at any time if compliance checks
provide evidence that the member organisation does not conform to, or is not operating in accordance with, the Proudly South
African criteria. In such a case any refund of the subscription fee will be entirely at the discretion of Proudly South African,
considering any administrative costs incurred.
b) The applicant organisation agrees in advance that, upon cancellation for any reason whatsoever, the member organisation will
provide a written confirmation to Proudly South African that the use of all Proudly South African materials and logos has ceased,
or will cease to be used immediately.

7. DURATION OF MEMBERSHIP
a) Your membership will be valid for 12 months after the date of payment. Your annual renewal membership fee will be invoiced
to you.

I certify that the information supplied in this application is correct and true - and agree that we will abide by all the terms
and conditions of membership as stated above.

Name and Surname Designation Signature Date

ISO 9001: 2015 QUALITY MANAGEMENT SYSTEM

©This Document is the property of PROUDLY SOUTH AFRICAN and may not be copied or distributed to any third party without the express permission of the CEO in consultation with the MRQ
 MEM-F: 01 Rev 7
MEMBERSHIP APPLICATION FORM November 2020
SCHEDULE B:
SECTOR
CLASSIFICATION
INDUSTRIAL MANUFACTURING (1) EDUCATION, DEVELOPMENT AND MEDIA MARKETING AND
Engines and parts (A) TRAINING (9) PUBLISHING (18)
Servicing of engines and motors (B) Pre-primary, primary and secondary Television media (A)
Industrial equipment (C) schools (A) Radio media (B)
Servicing and refurbishing (D) Private colleges (B) Newspapers (C)
Fuel, lubricants and detergents (E) Tertiary institutions (C) Magazines (D)
Educational services (D) Media services (E)
CONSTRUCTION ENGINEERING Educational products (E) Advertising, marketing, design and PR
AND ARCHITECTURE (2) Educational projects (F) agencies (F)
Architecture and design (A) Other education organisations (G) Out-of-home advertising (G)
Construction (B) Events, conference and exhibition
Building and construction products (C) COMMUNITY ORGANISATIONS services (H)
Building and construction services (D) AND PROJECTS (10) Specialised media programmes and
Engineering and related services (E) REPRESENTATIVE projects (I)
Electronic products and systems (F) ORGANISATIONS (11) Book publishers (J)
Trades unions (A)
MANUFACTURERS (3) Professional bodies and associations MEDIA PRODUCTION SERVICES
Chemical (A) (B) (19)
Electrical appliances and equipment (B) Industry associations (C) Film, video and TV production (A)
Hand and machine tools (C) Production services (B)
Plastic products (D) PROFESSIONAL SERVICES (12) Reproduction and print (C)
Automotive, aviation, marine and rail Training services (A) Signage (D)
products (E) Management and consulting services Promotional items (E)
Furniture and fittings (F) (B) Printers and screen printers
Glass products (G) Personnel and related services (C) (F)SPORT (20)
Cleaning equipment (H) Legal and related services (D) Sports teams (A)
Board, paper and stationery products Other services (E) Sports organisations (B)
(I) Sports products (C)
Packaging products (J) GOVERNMENT (13) Sports events (D)
Safety and security products (K) National government body (A) Sports other (E)
Pool and garden products (L) Provincial government body (B)
Household appliances (M) Local government body (C) CULTURE, ENTERTAINMENT,
Fabrics and textiles (N) Statutory body (D) MUSIC AND RECREATION (21)
Clothing and footwear (O) Government project (E) Performing bodies (A)
Household consumer products (P) Entertainment services (B)
FINANCIAL SERVICES (14) Recording companies (C)
CRAFTS AND HOME INDUSTRIES (4) Short term and life assurance (A) Events and productions (D)
MINING AND BENEFICIATION (5) Accounting and auditing (B)
Mining - metals and jewellery (A) Banking, securities and investments TRANSPORT AND LOGISTICS (22)
Mining - other resources (B) (C) Freight, couriers and logistics (A)
Mining equipment and services (C) Professional and financial services (E) Other services (B)
Jewellery manufacture (D)
Jewellery retail (E) INFORMATION TECHNOLOGY AND TOURISM, TRAVEL AND
TELECOMMUNICATION (15) HOSPITALITY (23)
AGRICULTURE (6) IT hardware (A) Air, road, sea and rail transport (A)
Dairy produce (A) IT software (B) Hotels and accommodation (B)
Livestock farming and processing (B) General services (C) Tour operators (C)
Viticulture and wineries (C) Internet and web products and Agents and organisations (D)
Agricultural equipment (D) services (D) Destinations and attractions (E)
Agricultural services (E) IT solution products (E)
General farming (F) Telecommunication services (F) EXPORT AND TRADE (24)
Marine and aqua-culture (G) Trading companies and agents (A)
Agricultural products (H) WHOLESALE AND RETAIL TRADE
(16) SERVICES (25)
FOOD PRODUCTS (7) National general retail chains (A) Household services (A)
Wholesale food products (A) Specialist chains (B) Personal services (B)
Retail food products (B) Independent retailers (C) Office services (C)
Beverage products (C) Restaurant chains and outlets (D)
Snack products (D) Distribution agents (E) UTILITIES AND MUNICIPAL
SERVICES (26)
HEALTHCARE (8) PROPERTY AND REAL ESTATE (17)
Over the counter health products (A) Estate agents (A)
Scheduled pharmaceuticals (B) Property and management services (B)
Health and lifestyle services (C) Other (C)
Medical and hospital products (D)
Medical and hospital services (E)
Veterinary products and services (F)

ISO 9001: 2015 QUALITY MANAGEMENT SYSTEM

©This Document is the property of PROUDLY SOUTH AFRICAN and may not be copied or distributed to any third party without the express permission of the CEO in consultation with the MRQ