Membership Application Form

KKDBC Membership Application
BUSINESS NAME
ABN or ACN
CONTACT PERSON

First Name Last Name
PHONE NUMBER
EMAIL ADDRESS
example@example.com
BUSINESS ADDRESS

Street Address

Street Address Line 2

City State

Post Code
POSTAL ADDRESS (If different from above)

Street Address

Street Address Line 2

City State

Post Code
ONLINE BUSINESS DIRECTORY INFORMATION

The following information will be available to the public on our website business directory, please do not include any information you do not want made public.
BUSINESS TRADING NAME
WEBSITE
CONTACT NAME (Customer Service)
CONTACT EMAIL
example@example.com
PHONE NUMBER (Customer Point of Contact)
BUSINESS DESCRIPTION
PAYMENT INFORMATION

Our financial year runs from 1 July to 30 June. Memberships are renewed annually.
FEES (GST is not applicable)
IS AN INVOICE REQUIRED
DIRECT BANK DEPOSIT (Preferred)

Newcastle Permanent

Name: Kurri Kurri District Business Chamber Inc

BSB: 650300

Account #: 546412808

OR by Cheque made payable to:

Kurri Kurri District Business Chamber Inc

PO Box 255, Kurri Kurri NSW 2327
Should be Empty:

KKDBC Membership Application