Application for Membership

Please complete the following form.
Application for membership is currently only available to groups/associations who have all of the following:

Each group/association must be incorporated.
Each group/association must have a safety policy.
Each group/association must hold public liability insurance to the limit required by State law.

Group/Association Full Name:
Contact:
Representative:
Email:
Postal Address:
Does the group have an ABN?
Website:
Incorporation No:
State Lodged:
Public Liability Policy No:
Amount Covered:
Expiry Date:
Name of Company Providing Insurance:
Group/Associations total membership (all classes) numbers:
Groups/Associations committee members are:
President:
Vice President:
Secretary:
Secretary's Email:
Public Officer:
Treasurer:
Other Committee Positions:


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