Membership Application

Join APSA

Complete the form below to apply for membership. All fields marked with an asterisk are required.

Personal Details
Please enter your name
Please enter your surname
Your HPCSA dental practitioner registration number Please enter your DP number
Please enter a valid email address
APSA Yearly Membership *
ℹ️ Membership fee details for each category will be communicated by APSA. Your application will be reviewed and processed once the relevant category requirements and fees are confirmed.
Payment Details

APSA Banking Details

Please use your name and surname as the payment reference

Bank
ABSA Bank
Cheque Account No
730140711
Branch Code
632005
Reference
Your Name & Surname
Email Proof of Payment
academyofprosthodonticssa@gmail.com
Supporting Upload
Optional. Small files only — up to 5MB. Accepted formats: PDF, JPG, PNG, DOC, DOCX.

By submitting this form you confirm that the information provided is accurate. APSA will email the application details via APSA's website mailbox and forward them on to academyofprosthodonticssa@gmail.com, including your uploaded file if one is attached.

✓

Application Received

Thank you for applying to join APSA. We will be in touch shortly with your membership confirmation and payment details.

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