To be completed by a registered social worker applying to register for a speciality in social work with the SACSSP as contemplated in section section 17C(1) of the Social Service Professions Act 110 of 1978 and the relevant regulations related to the registration of specialities in social work.

Fees are to be paid into the bank account of the SACSSP Account name:

SACSSP Bank: NEDBANK

Account number: 1190739410

Branch: MENLYN MAINE

Branch Code: 198765

Reference: A reference number must be provided for every deposit