MUSIAD MELBOURNE MEMBERSHIP APPLICATION FORM

Independent Industrialists and Business people Association

Name*

First NameLast Name

Birth Year

Birthplace*

Address*

Mobile Phone*

Personal Email*

example@example.com

Business Name*

ABN

Sector*

Your Role*

Website

Address

Business Phone

Business Email

example@example.com

Independent Industrialists and Business people Association

admin@musiadmelbourne.com.au www.musiadmelbourne.com.au

Independent Industrialists and Business people Association

Please choose your preferred membership category.

Honorary and Advisory members can only be nominated by The Board.

Platinum Membership is for any Corporation, Partnership, Sole Proprietorship which is a commercial entity, who is currently involved in trade in Australia or is intending to trade in and or with Australia. Platinum membership is the highest category membership of MUSIAD and offers a list of benefits from MUSIAD partners. MUSIAD Melbourne Board members can only be appointed by Platinum Members. Annual membership fee for this category is $1,000.00

General Membership is for any small business, sole-traders and professionals who are either self-employed or in full-time part-time or casual work. Annual membership fee is $250.00

Refer to MUSIAD Melbourne website for more details on membership and how to join Musiad Melbourne.

Independent Industrialists and Business people Association

admin@musiadmelbourne.com.au www.musiadmelbourne.com.au

Independent Industrialists and Business people Association

I am interested in below MUSIAD Melbourne activities for the following reasons

Networking eventsBusiness seminars and trainingSocial and community wellbeing activitiesLobbying for our members and our communityBusiness and joint venture opportunitiesOther (please advise):

By signing below, I accept all terms and conditions listed in the constitution of MUSIAD Melbourne.

Name*

First NameLast Name

Signature (type name)

Please note that this application will not guarantee your membership approval, your membership must be approved by the Board. Terms and conditions apply, please refer to MUSIAD Melbourne website for further details.

Independent Industrialists and Business people Association

admin@musiadmelbourne.com.au www.musiadmelbourne.com.au

Independent Industrialists and Business people Association

Please submit your annual membership payment to below account and then send a confirmation email to.

Account name: Musiad Melbourne Incorporated

BSB: 063135

Account number: 10932446

Description/Reference: (Your Name)

OFFICE USE ONLY REFERENCES

Signature

Reference (2)

Signature

Approval date

Date

Membership number

Independent Industrialists and Business people Association MUSIAD MELBOURNE INCORPORATED admin@musiadmelbourne.com.au www.musiadmelbourne.com.au

MEMBERSHIP APPLICATION FORM

APPROVAL