Membership Application Form Oct 3 2013.Indd

Membership Application Form Oct 3 2013.Indd

Australian Association of Bush Regenerators Inc.

A: c/o Total Environment Centre, P.O. Box K61, Haymarket NSW 1240

M: 0407 002 921

E:

W:

ABN 33 053 528 029

Membership Application form for Organisation

Australian Association of Bush Regenerators Inc.

(incorporated under the Associations Incorporation Act 2009)

Personal details and declaration (will not be disclosed outside AABR)

I, (first name) …………………………….………… (last name) ………………………………………… am the formal representative of

Organisation name ………………………………………………………………………………………….

which wishes to apply for Membership* of the Australian Association of Bush Regenerators Inc.

postal address ………………………………………………………………………………………………………………….……

suburb / town ….…………………………………………………….. state ……………….. postcode ………………….…..

telephone (land line) …………………………………………… Mobile: ……………………………………..…………….…

email .………………………………………….……Website………….…………………………..…….….

If admitted as a member, our organisation agrees to be bound by the constitution of AABR (available at

We wish to receive newsletters as (tick ONE box):

Electronic PDF (emailed)

OR

Hardcopy (posted)

Signed ……………………………………………………… Date ………………………………

*Does not confer membership to individuals in that organisation or ability to use AABR logo in association with your organisation’s name.

SEE over page on how to send this form and make your membership payment.

Payment of fees & Sending your application form

Business (less than 5 employees) $120
Business (5-20 employees) $300
Business (More than 20 employees) $480
Agency (government) $60
Not for profit $30 (or $0 if newsletter exchange arranged)

Your Payment (using the above fee scale):

Organisational Membership ……… year/s = $…………

Donation = $…………

Total = $…………

Methods of payment & Sending form (please tick 1 box):

Option 1: Internet Banking + Email

STEP 1) Transfer your payment from your financial institution to our ANZ account:

  • Account name: Australian Association of Bush Regenerators Inc.
  • BSB: 012 842
  • Account number: 338123665
  • Transfer reference: your name and, if space allows, what the payment is for.

STEP 2) You MUST email banking transfer details & application form to :

  • Subject “Annual fee payment”
  • Your full name
  • Date of banking transfer
  • Amount transferred
  • What the payment was for, eg. $30 annual membership fee + $10 donation
  • Attach a completed electronic copy of this application form
  • IF you want your receipt made out to another name, tell us the name & address details

NOTE: if you don’t email these details plus your completed application form, we won’t be able to create a membership for your organisation.

Option 2: Cheque or Money Order + Post

Post this completed form and your payment to the address on the front of this form.

Make cheque/money order out to “Australian Association of Bush Regenerators”.

for helping AABR to support

the bush regeneration industry

and protect our natural heritage.

______

OFFICE USE ONLY

Approved:_ / _/ Notice sent: _/_ / Fees received: /_ / Member No.

Lapsed:_ / _/

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