SPONSORSHIP REQUEST APPLICATION FORM

							E7     SASOHN SPONSORSHIP APPLICATION FORM
Note: incomplete applications will not be considered.

Name:           ___________________________________________________________________
Company:        ___________________________________________________________________
Address:        ___________________________________________________________________
                ___________________________________________________________________
Tel no :        __________________________            Fax no: _______________________________
Cell:           __________________________            Region: _______________________________
SASOHN membership number:              _________________________________________________


Details for which sponsorship is requested: ________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Amount requested: _____________________________________________________________
Have you received sponsorship from the SASOHN National Body before: __________________
If yes, give details:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Define your level of activity with SASOHN as per the constitutional definition:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Please attach the following documents:
Attachment 1 – Request to own company
Attachment 2 – Reply from own company with permission to attend if application successful
Attachment 3 – SA Nursing Council receipt (current)
Attachment 4 – SASOHN Membership receipt (current)
Attachment 5 – Proposed budget
Attachment 6 – Regional Committee Decision
Attachment 7 - Any additional supporting documentation

FOR OFFICE USE
National committee response
Is the request upheld:_____________________________________________________________
______________________________________________________________________________
Signed: (President) ____________________Signed: (Treasurer) ___________________________
Date: ___________________________ Date member has been informed: ___________________


Originated: 1988                                                   Review date: April 2008
Updated: April 2006                                                           Page 1 of 1
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