Please tell us why your organisation is applying for SAMRA membership *

Organisation profile *

Please upload any brochures or a profile of your organisation or business unit/department in pdf format, explaining what you do and who you are

All details and information submitted is strictly confidential.

ORGANISATION DETAILS

Please identify the organisation

Registered name of the organisation *

Trading name *

Registration number *

Country of registration *

Year registered *

Year established *

Is the above organisation primarily: *

Annual TURNOVER GENERATED FROM data, analytics, research, sample, panel, research-related information technology and software, and/or related consulting/advisory services and products, as at the end of the organisation's last completed financial year *

Please exclude VAT

Annual SPEND ON data, analytics, research, sample, panel, research-related information technology and software, and/or related consulting/advisory services and products, as at the end of the organisation's last completed financial year *

Please exclude VAT

SECTOR(S) in which research was done by the organisation in the last 12 months *

Categories are based on the ESOMAR global classification system.

	Yes	No
Manufacturing: Consumer Non-Durables (FMCG)
Manufacturing: Consumer Durables
Manufacturing: Pharmaceutical products and services (Rx – prescription)
Manufacturing: Automotive
Manufacturing: Other
Business-to-business and industrial
Wholesale and retail (incl. oil, commercial farming, agriculture)
Financial services
Utilities (incl. gas, electricity, water, private and public postal services, etc.)
Telecommunications and Information and Communications Technology
Public sector, academic and public institutions, NGOs
Media, entertainment, tourism and hospitality
Advertising agencies, Strategy and communications companies, Brand consultants
Research institutes

QUANTITATIVE methods used by the organisation in the last 12 months *

Categories are based on the ESOMAR global classification system.

	Yes	No
Postal mail self-completion questionnaire
Telephone interviewing (CATI) (including CATI to mobile)
Face-to-face interviewing (PAPI/CAPI)
Self-completion questionaire using an online device
Online traffic / audience measurement, including website measurement
Automated digital/electronic including retail audits and media measurements and interactive voice recording interviews

QUALITATIVE methods used by the organisation in the last 12 months *

Categories are based on the ESOMAR global classification system.

	In-person/face-to-face (not online)	Online/internet-based	Both	None
Group discussions / focus group interviews
In-depth (individual) interviews
Communities and panels
Self-reporting (e.g. vox pops, blogging, written diaries, photo diaries)
Observation (e.g. ethnography, immersions, shopper research)

BIOMETRIC MEASURES used by the organisation in the last 12 months *

	Yes	No
Facial coding
Eye-tracking
Functional magnetic resonance imaging (fMRI)
Positron emission tomography (PET)
Electroencephalography (EEG)
Steady state topography (SST)
Transcranial magnetic stimulation (TMS)
Electro Dermal Activity (EDA)/galvanic skin response
Electromyography
Electrocardiography (ECG)
Implicit Association Test (IAT)

DESIGNS used by the organisation in the last 12 months *

Categories are based on the ESOMAR global classification system.

PROPOSED ASSOCIATE MEMBERS

Click on the link provided for Part C of the application, save and complete the template and then submit the list of proposed Associate members to the SAMRA Office via email (membership@samra.co.za)

Headcount *

All permanent full-time and part-time employees who take any level of responsibility for or work directly with data, analytics, research, sample, panel, research-related information technology and software, and/or related consulting/advisory services and products, as at date of submission of the Associate list. Please exclude any temporary employees or independent contractors.

I hereby certify that: *

I have not included temporary employees or independent contractors in the above headcount

I have submitted a proposed list of Associate members for this Organisation Membership using the specified template

All proposed Associate members have been informed of the rights and responsibilities of SAMRA membership, and have agreed to adhere to the requirements for SAMRA membership

TERMS AND CONDITIONS

I, the authorised representative for the above organisation applying for SAMRA Organisation Membership, hereby certify that: *

Select Yes to indicate agreement

	Yes
The information set out in this submission is true and correct to the best of my knowledge.
The above organisation will abide by the Southern African Marketing Research Association (SAMRA) Memorandum of Incorporation and Company Rules, and the SAMRA Code of Conduct.
I undertake, on behalf of the above organisation, to ensure payment of any fees due to SAMRA.
I accept liability on behalf of the Organisation for the once-off, non-refundable application fee that becomes due when I submit this application form.
I understand that, if approved, the organisation will remain a member of SAMRA until such time as a valid resignation is submitted to and received by SAMRA, or membership is withdrawn by SAMRA.
The above organisation meets the criteria for SAMRA Organisation Membership.
I understand and agree that by submitting this application form I am liable for the non-refundable application fee at the time of this submission, which is payable before the application is considered. Once invoiced, this application processing fee remains due, irrespective of whether the application expires after 120 days, or is approved or not.

	Yes	No
Ad hoc research
Omnibus (syndicated) surveys
Panel research
Other continuous tracking research

Organisation Membership Application – Part A

ORGANISATION DETAILS

PROPOSED ASSOCIATE MEMBERS

TERMS AND CONDITIONS

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