wild card application form - capenature€¦ · wild card application form kindly complete the...

Wild Card Application Form

Kindly complete the information below to renew or obtain a new wild Card.

Forward this back with a proof of payment to receive your confirmation letter. Your confirmation

letter can be used while you wait on your card to be sent.

Herewith the banking details:

Banking Details

Bank Name NedBank Ltd

Account Name WCNCB bank account

Branch Name Corporate

Account Type Cheque

Account Number 1 452 048 401

Branch Code 145 209

Reference Wild Card – Name and Surname

Please select your card type

Type of Card All parks CapeNature SanParks Msinisi EKZN

Wildlife

Swaziland International

Individual

( Any 1 pax)

R 515.00 R 455.00 R 500.00 R 455.00 R 500.00 R 370.00 R 2210.00

Couple

( Any 2 pax)

R 845.00 R 740.00 R 815.00 R 745.00 R 810.00 R 605.00 R 3455.00

Family

( up to 7- max

2 adults)

R 1035.00 R 890.00 R 975.00 R 885.00 R 970.00 R 735.00 R 4130.00

Personal Details

Old Wild Card Number if any

Title

First Name

Surname

ID Number

Email

Postal Address and code

Suburb

Cell phone number

Home Telephone Number

Work Telephone Number

Fax Number

Language

Ethnic Group

Nationality

Couple Card additional information

Partners Name

Surname

Gender

ID Number

Ethnic group

Nationality

Family Card ( 2 adults and 5 children up to the

age of 17)

Dependant D.O.B or ID number and gender

1.

2.

3.

4.

5.

Please direct all Wild Card queries to sgamieldien@capenature.co.za alternatively on 021 483 0074.