Membership Application 2021

Early Childhood Development Centres:

Please note that if you are an Early Childhood Development Centre (ECD), you will have to register to become a member of our ECD Partner, Inceba Trust by clicking here. Your Inceba Membership will grant you access to Valcare benefits.

Saving this Form:

Please note that this form can't be saved and will need to be completed and submitted in one go. To ensure a quick and seamless process, we recommend that you check and prepare all required information and documentation before commencing. It will take about 10 minutes to complete.

Name of organisation *

Office number *

General Organisation E-mail *

Facebook page address

Website

Current number of paid staff members at your organisation *
01-56+

First Name *

Last Name *

Job title *

Cellphone no *

E-mail *

First Name *

Last Name *

Job title *

Cellphone No *

E-mail *

Building/house number *

Street name *

Suburb *

Number of beneficiaries per age group *
Children 0-5
Children 6-12
Children 13-18
Young Adults 19 - 25
Young Adults 26-35
Adults 35-59
Elderly 60+
Total number of beneficaries

Did any of your organizational details change? if yes , please provide us with the details by emailing it to admin@valcare.org.za
YesNo