New Membership

Grade of membership required Ordinary Honourary Associate

Company Details Company Name

Address Address1 Address2 City State Postcode Country

Telephone Area Phone

Fax Area Fax

Representative Full name of representative

Address Address1 Address2 City State Postcode Country

Telephone Area Phone

Fax Area Fax

Email Is representative normally resident in the region? Yes No

Is the applicant a joint venture company? Yes No Is any shareholder a member of this association? Yes No If yes, what is shareholding? Major Minor 50/50