MEMBERSHIP APPLICATION FORM

Please select one of the three membership grades available:

Individual Member- $100 per annum.An Individual Member hasfull rights to participate and vote at meetings, receives copies of minutes, reports and CIE News and may purchase CIE publications at discounted rates.

Organisation Member- $250 per annum. A representative from the organisation must be nominated as the contact person and receives the same benefits as an individual member on behalf of the organisation.

Organisation Member (Sustaining)- $600 per annum. A representative from the Organisation must be nominated as the contact person and receives the same benefits as an individual member on behalf of the organisation. Four (4) additional representatives may be nominated as Individual Members without voting rights.

Organisation Membership only
Organisation Name:
Website:
Address:
(if different from below)
City: / State: / Postcode:
Representative of Organisation and Individual Membership
Title: / First name: / Family name:
Postal Address:
City: / State: / Postcode:
Occupation:
Telephone: / Fax:
Email: / Mobile:

Please select a Method of Payment:

Cheque made payable to “CIE Australia” / Mailchequewith application to:
CIE Treasurer
50 Redcliffe Gardens Drive
Clontarf, QLD, 4019
PayPal (also accepts credit cards) via CIE Australia website ( / Emailtransaction notification and application to:

EFTBSB 083 590 (National Bank, Clayton, VIC)
Account Number 04 785 3342
Account name CIE Australia

CIEOzMembershipForm_2016 v4Rev: 1 December 2018

CIE Australia

The Australian National Committee ofRegistered as CIE Australia Inc.

the International Commission on IlluminationAssociations Registration No: A0022976Z

32301390692

Additional Information
This information will assist the organisation in providing
relevant notifications to interested members.
Other Memberships/ Affiliations / IES ANZ / IALD / IES NA
AOS / MSA / IE Aust
CSA / LCA
Others (please specify)
CIE Division Interests / Division 1 / Vision and Colour
Specify particular
areas of interest
Division 2 / Physical Measurement of Light and Radiation
Specify particular
areas of interest
Division 3 / Interior Environment and Lighting Design
Specify particular
areas of interest
Division 4 / Lighting and Signalling for Transport
Specify particular
areas of interest
Division 5 / Exterior Lighting and Other Applications
Specify particular
areas of interest
Division 6 / Photobiology and Photochemistry
Specify particular
areas of interest
Division 8 / Image Technology
Specify particular
areas of interest
CIE Technical Committees / Specify current
TC memberships
Declaration: / I hereby undertake, as a financial member (individual or organisation) of CIE Australia, to only use the “CIE Membership Code” for my discounted purchases of CIE publications and not to divulge to, or purchase discounted publications on behalf of, non-members.
Signed:

CIEOzMembershipForm_2016 v4Rev: 1 December 2018

CIE Australia

The Australian National Committee ofRegistered as CIE Australia Inc.

the International Commission on IlluminationAssociations Registration No: A0022976Z

32301390692