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DSA Events held
Denim For Diabetes - School Day
Durban Lifestyle Meetings
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DSA Contacts
Durban
0861 222 717
East London
082 327 1571
Kimberley
082 923 4620
Lenasia
011 852 5773
National Office
086 111 3913
Pietermaritzburg
033 346 0934
Port Elizabeth
082 579 9059
Pretoria
083 574 0959
Western Cape
021 425 4440
Initials:
Name:
Surname:
Home Contact Number:
Work contact Number:
Cell Number:
Occupation:
I.D. Number:
Address:
City:
Province:
Postal Code:
Age:
Email Address:
Race:
Diabetes Type:
Number of Years as a Diabetic:
Method of Control:
Single annual Membership:
(Includes 4 copies of Diabetes Focus)
Network annual Membership:
(Includes 4 copies of Diabetes Focus)
Donation Amount: