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SA Transplant Sports Association

Optimising the Quality of Life of Organ Transplant Recipients,
Through Sports and Other Physical Activities

admin@transplantsports.org.za

SA Transplant Sports Association

Optimising the Quality of Life of Organ Transplant Recipients

HOME
ABOUT
- VISION & OBJECTIVES
- CONSTITUTION
SPORT
MEMBERSHIPS
Documents
Media
Contact
Newsletters

SA Transplant Sport Association Membership Application

Membership Application

Personal details:

Title

ID Number

First Names

Surname

Postal Address

Town

Province

Code

Email

Cell

Phone

Fax

Work details:

Employed Full Time

Employed Part Time

Unemployed

Student

Retired

Homemaker

Work Phone

Work Fax

Work Email

Category Membership:

Transplantation History:

Organ/s

Transplant Date

Hospital

PARTICIPATION IN SPORTS ACTIVITIES:(only organ recipients)

Checkboxes

Golf

Table Tennis

Squash

Ten Pin Bowling

Checkboxes

Petanque

Tennis

Road Running

Checkboxes

Swimming

Badminton

Cycling

Darts

Track & Field Disciplines

Sprints

Middle Distances

Long Distances

Walks

Jumps

Throws

Road Running

Other Activities

Who referred you to us, we'd like to send them a thank you

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