Membership Form - Doctors

        

your ultimate vitiligo resource

 
 

Membership is free and automatically includes all members of the Dermatology Society of South Africa.


For voluntary donations, please deposit your payment in the account of:


The Vitiligo Society of South Africa

First National Bank

Overport Branch

Branch Code:  222826

Account number:  62187490372


Please use your initials and surname as reference.


Alternatively, you may print, fill and fax this form and your deposit slip to the secretary of the Vitiligo Society at 086 546 8773. 


Please note that e-mail will be the only method of communication.