ASSOCIATE MEMBERSHIP 2023

ASSOCIATE MEMBERSHIP 2023
AMEC MEMBERSHIP 2023

ASSOCIATE MEMBER
Contact details
Company Name:*
ABN:*
Principal business activity:*
Postal Address:*
City/Suburb:*
State:*

New South WalesVictoriaQueenslandSouth AustraliaWestern AustraliaNorthern TerritoryTasmaniaAustralian Capital Territory
Postcode:*
Telephone:*
Web Address (URL):
Key Company Representative:*

DrMrMrsMs
Name

First NameLast Name
Position/Title:*
Email*
example@example.com
Mobile:*
Managing Director/CEO:
Position/ Title:
if the same as above, please ignore this field.
Managing Director/CEO Email:
example@example.com
Accounts Contact:
Accounts Contact Email:
example@example.com
Other Company Contacts
1. Name:
Position:
Email:
example@example.com
2. Name:
Position:
Email:
example@example.com
Subscriptions & Fees

Category	Fees (excl GST)	Fees (incl GST)
Level 1 (0-20 Employees in Australia)	$1310	$1,441
Level 2 (21-100 Employees in Australia)	$3,060	$3,366
Level 3 (101+ Employees in Australia)	$4,220	$4,642

Please select the relevant category:*
Number of employees (including contractors)*

1-2021-100101-199200+400+
Service provided*

DrillingEnvironmentalFinancialGeo & Lab servicesICTLegal and TenementMedia & CommunicationOther
Reason for joining AMEC (Please check relevant box(es)):*

Advocacy/LobbyingNetworkingAccess to InformationInsurance FacilityConferences & EventsOther Commercial BenefitsSupport the Industry
What other services could AMEC offer?
Privacy statement
In accordance with the data privacy act, AMEC does not disclose members contact details to third parties. The purpose of collecting contact information is to process membership and keep members up-to-date with policies, advocacy activities, networking events and general AMEC information.
If you do not wish to receive further information, please tick this box.
Date:*

DayMonthYear
Date
Method of payment (Please tick)*

EFT (Bank details will be sent on submission of form)Debit/Credit Card (Secure payment accepted below)
Secure Debit/Credit Card payments accepted below. If paying by EFT, please skip this section, and press "Submit".

Application Fee per year (Fees inclusive of GST)

Level 1$1,441.00AUD

0-20 Employees in Australia.

Level 2$3,366.00AUD

21-100 Employees in Australia.

Level 3$4,642.00AUD

101+ Employees in Australia.