Membership Application Form 2023

Membership Application

Macedon and Mount Macedon Community House Inc. ABN: 50871098274
Name*

Given NameLast Name
Business/Organisation Name
If applicable
Address*

Street Address

Street Address Line 2

TownState / Province

Post Code
Postal Address*
If different from above
E-mail*
example@example.com
Phone Number

Area CodePhone Number
In order to become a member of Macedon and Mount Macedon Community House Inc. applicants must agree to support the purposes of the organisation and agree to abide by the rules of the organisation:

Please indicate your agreement by checking the two statements below:
*

I support the mission and purposes of the organisation (as linked above)
*

I agree to abide by the model rules adopted by Macedon and Mount Macedon Community House Inc (as linked above)
Signature*

Clear
Signature Date

MonthDayYear
Date
ANNUAL MEMBERSHIP SUBSCRIPTION
Fees have been waived for all new members joining in 2023. Notification of the annual membership subscription fees for new and renewing members in 2022 will be made before 2024 AGM.
Type of membership (please pick one)*

IndividualFamilyBusiness/Organisation
Business/Organisation name: if applicable
Please verify that you are human*
The Committee of Management will consider applications for membership as soon as practicable after their receipt and resolve to accept or reject an application. Applicants will promptly be notified in writing of the outcome.

Your information will be held by the Committee of Management in strict confidence and will not be shared with any third parties.
Should be Empty: