Application for Membership

To be completed by the applicant

* All mandatory fields must be filled in

Section 1 - Personal Details

Surname *
First Names *
Addresses	(Please select the address you want your mail sent to)
	Residential *		Company *

Home Phone *		Company Name *
Home Fax		Current Position Held
Home Email *		Work Phone *
		Work Email *
		Work Fax
Describe duties undertaken in current position


Membership Class *		Membership Fees
(Please select the membership class you are applying for)		Individual Member.......................................$210.00 (inc GST) Corporate......................................................$460.00 (inc GST) Student & Retired........................................$90.00 (inc GST)