APPLICATION FOR MEMBERSHIP (ORGANIZATION)

Membership Details Form

Company Name: *

ACN/ABN: *

Business/Organisation Main Interest: *

(please provide a brief description of your main business and your organisation’s interests and activities)

Website:

Registered Office: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Postal Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Primary Contact

Will be the designated person within your organisation who will receive formal communications from IDCC about voting on behalf of your organisation and nominations for the board.

Primary Contact: *

First Name Last Name

Mobile Number: *

Country Code Number

E-mail: *

example@example.com

CEO (or representative)

From time to time the IDCC Board may contact CEOs or their nominated representative for high-level engagement in selected meetings. Please provide details below, if different to your organisation’s Primary Contact.

Name:

First Name Last Name

Title:

Mobile Number:

Country Code Number

E-mail:

example@example.com

Organisational Contacts for General Correspondence

Please list here any people in your organisation who should be included in IDCC’s Member Updates and general correspondence.

Organisation Contacts for General Correspondence *

Membership Fee & Voting Rights

Member Type	Annual Fee	Votes	GST	Total Fee Payable
Large organisations (with contract values exceeding $50 million)	$6,000	3	$600	$6,600
Medium organisations (with contract values between $5 million and $50 million)	$2,400	2	$240	$2,640
Small organisations (with contract values less than $5 million)	$1,000	1	$100	$1,100

*Voting rights refer to electing directors and making amendments to the constitution.

Select Membership Category *

Large organisations Medium organisations Small organisations

Method of Payment *

EFT (Bank details will be sent on submission of form) Debit/Credit Card (Card details will be requested on submission of form)

Please verify that you are human *

APPLICATION FOR ORGANISATION MEMBERSHIP