FORM NO. CST 4
THE COPYRIGHT SOCIETY OF TANZANIA, COSOTA
THE COPYRIGHT AND NEIGHBOURING RIGHTS ACT, 1999
(NO. 7 OF 1999)
INDIVIDUAL MEMBERSHIP APPLICATION FORM
____
(Made under Regulation 7)
_____
(Fee 5,000)
1.
Surname …………………………………………………………………………………………..
(Jina la Ukoo)
2.
First name(s) …………………………………………………………………………………….
Majina mengine)
3.
Pseudonym (if any)……………………………………………………………….………….
(Jina la Kisanii)
4. Date and Year of birth ………………………………………………………………………………..
(Tarehe na mwaka wa kuzaliwa)
5.
Place of birth ……………………………………………………………….……………………
(Mahali ulipozaliwa
6. Home address: village …………………….(Ward……………… District……………………….
(Anwani ya (kijiji) (mtaa) (wilaya)
nyumbani)
7. Contact address, P.O. Box ………………………………………………….……………….
(Anwani ya
mawasiliano
kikazi)
(S.L.P.)
Telephone ……………………………………………………………….
(Simu)
Fax………………………………………………………………………….
( )
Email …………………………………………………………………….
(Simu pepe)
5