Membership Application Form 2021 - 2022
Please select the membership level being applied for, remember to refer to Membership Prospectus to determine which category you are eligible to apply for. Please do not hesitate to contact us if you have any questions.
Membership Level
Industry Investor - $3,000.00
Industry Partner - $350.00
Industry Producer -$250.00
Industry Business Supporter - $250.00
Industry Association Support - $50.00
Not for profit / volunteer organisation $100)
Contact Details
Primary Contact Person
Name
First Name
Last Name
Position in Business
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Business Details
Business Name
Business ABN
Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website Address
General Information
Do you consent for your information to be added to the Kangaroo Island Tourism Food Wine and Beverage Association data base?
Yes
No
Do you consent to your business information being shared with the following entities?
SATC
TOURISM AUSTRALIA
TICSA
FOOD SA
PIRSA
SOUTH AUSTRALIA WINE INDUSTRY ASSOCIATION
OTHER MEMBERS
FUNDING BODIES
Do you have an ATDW listing
YES
NO
Please provide us with a description of your business.This description is used by Kangaroo Island Tourism Food Wine and Beverage Association staff to better understand your business and the services you offer and to assist with the appropriate placement of your business listing within our digital resources. (Please attach word document if you need more space.)
The following is a list of categories – please tick relevant to your business
Eating out / places to eat and drink
Farm Gate
Cellar Door
Producer
Accommodation Provider
Activity / Experience
Tour /Tour Provider
Arts and Culture
Transport and Transfers
Business Services
Please acknowledge the following:
I/We have read the Kangaroo Island Tourism Food Wine and Beverage Code of Ethics
I/ We agree to the Kangaroo Island Tourism Food Wine and Beverage Code of Ethics
I /We declare the business, as named in the application, has of the necessary licenses to legally conduct the business as outlined in the business description
I/ We declare that we hold all the necessary insurances including public liability to legally conduct business
Signature
Date
Submit
Should be Empty: