Membership Form

Full Name* (Plus Title)

Current Address

Phone Number

Email Address

Membership is Annual – 1 July to 30 June.
Personal Membership (Individual): Fee $50
Association Membership: Fee $75
Corporate Membership: Fee $250
Optional: Donation $
Please specify which Membership category applicable:

Type of membership or Donation ($$)

We will email you shortly with information on how to make your payment and finalise your request. Thank you for your support.

Declaration upon submitting this form:

I agree to guarantee any unpaid or outstanding amount of my membership fees to the Company.

DIRECT DEPOSIT: Westpac BSB 032-769, Acct No. 44-8206 REFERENCE: INITIAL SURNAME POSTCODE * and email Proof of Payment to