FPA Membership Application - Hartbeeshoek Fire Watch

Hartbeeshoek Fire Watch is a community website — it is NOT the MFPA and does not represent any Fire Protection Association. This form only helps you complete the official MFPA membership application. When you submit, we generate a filled PDF and attempt to email it (with the fee schedule) to the MFPA, copying you. Following up with — and if necessary submitting directly to — the MFPA remains your responsibility. See the MFPA membership fees and our Privacy Policy.

1. Applicant Details

Full Name (Title, Initials and/or First Names, and Surname)

Email Address

Name of Business (if applicable)

Farm Name, Common Name, Number, or Traditional Authority

Title Deed Number

Physical Location

GPS Latitude

GPS Longitude

Area (Hectares)

Vegetation Type

Personnel Details (trained levels, untrained count)

List your trained and untrained firefighting personnel with training levels.

Equipment Available (water tankers, bakkie-sakkies, knapsack sprayers, fire-beaters, rake-hoes, etc.)

List all firefighting equipment available on your property. See equipment requirements for guidelines.

Water Supply Point Details and Type

Water Supply GPS Latitude

Water Supply GPS Longitude

4. Declarations

I have read and understood the National Veld and Forest Fire Act No. 101 of 1998

I have read and understood the constitution of the Madibeng Fire Protection Association

I have read and understood the Rules of the Madibeng Fire Protection Association

I agree to abide by the constitution and rules of the Madibeng Fire Protection Association

POPIA Notice: By submitting this form, your personal information will be collected and processed for the purpose of MFPA membership application processing. Your data will be forwarded to the MFPA and stored securely. You may request access, correction, or deletion of your data at any time. Read full Privacy Policy.

I consent to the collection and processing of my personal information as described in the Privacy Policy

5. Signature

Digital Signature (type your full name)

Date

Community Verification

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Don't have the password? Contact us to request it.

Community Password

Your application will be forwarded to the MFPA for review. Membership is valid subject to annual subscription fee payment.

This form is based on the official MFPA Application Form. Contact MFPA directly at Madibengfpa@gmail.com or Chair Mr. Mosue SS: 081 352 1269.

MFPA Membership Application

1. Applicant Details

2. Contact Persons (in priority of emergency response)

Primary Contact

Second Contact (optional)

Third Contact (optional)

Fourth Contact (optional)

3. Firefighting Capacity

4. Declarations

5. Signature

Community Verification