Organisation Membership Application

Organisation Membership Application
This form is an opportunity for IPAA Victoria to collect the most up to date information about your organisation so we are able to provide the highest level of benefit possible.

For all category definitions see https://www.vic.ipaa.org.au/membership/
Membership level of interest*

Silver (small)SilverGoldCorporate Partner
Your PO or reference number if applicable
Organisation Name*
This field will appear as entered on your record
Sector*
Primary contact first name*
Primary contact last name*
Primary contact position title*
Primary contact email*
example@example.com
Primary contact phone*
03 9100 9100
Primary contact mobile
example: 0400 000 000
CEO first name*
CEO or Corporate Head
CEO second name*
CEO or Corporate Head
Position title*
CEO or Corporate Head
CEO email*
example@example.com
Accounts email*
Your accounts payable email
Accounts Phone Number*
eg. 03 9100 9100
ABN*
Description of Organisation
Number of staff*
(FTE)
Address line 1*
City*
State*
Post code*
Should be Empty: