Member Registration Form

Full Name

Email Address

Type of Membership (Choose 1)

"I have read the Masiyembo Ethos and commit to the Philosophy, Principles and Practices"

Motivation Statement

Bio / Profile (to be featured on the website, max 150 words)

Qualifications, Certifications or other Skills

Your Profile Image (min. size 800 x 600 pixels)

Banner Image (e.g. of a landscape that you work/thrive in, min. width 2000 pixels)

Description of your Offering (only for Offering Member or Organisational Member applicants)

Your Organisation's Logo(s) (if relevant)

Your Website(s)

Social Media Links

Optional Video Introduction

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