Landcare Victoria Inc 2025/26 Membership Application Form

NOTE: NEW MEMBERSHIP APPLICATIONS ONLY - THIS FORM CANNOT BE USED TO RENEW AN EXISTING NON-FINANCIAL MEMBERSHIP

Please complete this form to apply for full membership of Landcare Victoria Inc for the period 1 July 2025 to 30 June 2026 (annual subscription) or 1 January 2026 to 30 June 2026 (6-month subscription). All memberships are thereafter renewed annually.

Applicants for full membership must:

Be an organisation (incorporated or unincorporated), not an individual
Be a not-for-profit
Have at least five members
Have purposes similar to the purposes of Landcare Victoria
Conduct activities similar to "normal Landcare activities" which are therefore coverable by our insurance package

All membership applications will be considered by the Landcare Victoria Inc Board as soon as practicable after they are received. A membership is not deemed active until the Board has resolved to accept the application and the membership fee has been paid.

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The membership subscription fee includes access to Landcare Victoria Inc's member services, including cover by the member insurance package for the full membership period.

The insurance package typically includes Public Liability, Association Liability and Voluntary Workers Personal Accident insurance policies - please refer to the current Insurance Overview for more information. Please note, an additional fee for insurance may apply in cases where an extension is required to cover a specific activity your organisation plans to undertake that is outside the scope of the base policies.

Your organisation’s total annual expenditure from the relevant financial year, as defined in Part 3 of this form, will determine which Membership Tier it is assigned to for the 2025/26 membership year.

All memberships expire on 30 June each year and must be renewed for ongoing access to Landcare Victoria's member services and insurance.

The following fee structure applies in 2025/26:

Tier	Reported Annual Expenditure	Annual Membership fee 2025/26 (GST inc.)	6-month Membership fee 2025/26 (GST inc.)
1	$0-999	$380	$228
2	$1,000-9,999	$580	$348
3	$10,000-99,999	$830	$498
4	$100,000-999,999	$1,450	$870
5	$1,000,000+	$2,000	$1,200

In the case of an organisation that only requires membership and insurance cover to commence from 1 January 2026 onward, a 6-month introductory subscription option is available. The membership fee for a 6-month subscription is equal to 60% of the stated annual fee for the relevant tier.

Payment may be made by EFT/bank transfer to our nominated Bank Australia account, or by credit card via Pin Payments (surcharge applies for credit card payments).

Introductory membership period:

Name of organisation applying for membership

Is the organisation a GROUP or a NETWORK?

Does the organisation operate as a not-for-profit?

In what year was the organisation established (if known)?

What is the organisation's legal structure?

What is your organisation's incorporation number?

If unsure, search at https://www.consumer.vic.gov.au/clubs-and-fundraising/incorporated-associations/search-for-an-incorporated-association

Does your organisation have an ABN?

What is your organisation's ABN?

Is your organisation registered for GST?

Is your organisation an endorsed Deductible Gift Recipient (DGR)?

Is your organisation a registered charity with the Australian Charities and Not-for-profits Commission (ACNC)?

Please select all Victorian Catchment Management Regions your organisation operates within. If it additionally or solely operates outside the state of Victoria, please select 'Other' and advise where (e.g. NSW or National).

Please indicate where your organisation operates outside Victoria (e.g. NSW, National or International).

Does the organisation currently hold, or has it ever held, an insurance policy which includes Professional Indemnity and/or Directors & Officers cover (including combined 'Association Liability' policies)?

If yes, please provide details. Include the name of the insurer(s) providing the cover, the type of policy, the dates of commencement and ceasing cover, and any gaps during this period when cover was not active:

Please attach a copy of your organisation's governing document (rules/constitution) if it has adopted one. All incorporated associations and/or registered charities must have a governing document which includes the organisation's purposes/objects.

If your organisation does not have a governing document, instead upload its statement of purpose.

Note: If your organisation has adopted the Model Rules from Consumer Affairs Victoria, please ensure you attach the version which includes your organisation's name and purposes, not the blank template!

For more information on organisational purposes, please see the FAQ at https://landcarevictoria.org.au/join.

Upload your 'statement of purpose' or governing document which details your organisation's purposes:

Please attach a copy of your organisation's membership list.

Include at minimum the full name and address for notice (postal or email address) for each member with voting rights, plus any positions held, such as 'committee member' and office bearer roles (Secretary, etc.).

List one member per row, e.g. if Bob & Sally Smith have a family membership which gives them one shared vote at your general meetings, then they should be listed together on the same row. Conversely, if they each hold individual memberships and get one vote each, then they should be listed separately (Bob Smith on one row, Sally Smith on another row) even if they share the same address.

If a membership is held by an organisation (school, local business, library, council, etc.), then please make this clear on your list (e.g. Member Name: John's Plumbing Pty Ltd, Address: John Roberts, 12 Main St, Bushy Creek).

Please do not include associate members without voting rights and children 15 years of age or under.

If your organisation is a network, include a list of each independent environmental subgroup in the network (e.g. Bushy Creek Landcare Group, Hollow Tree Landcare Group, Friends of Mossy Park).

If your organisation has employees, also include a list of staff (full name, address for notice and position title, e.g. Facilitator).

For more information about membership lists and to download a basic list template, please visit https://landcarevictoria.org.au/join.

Upload your organisation's membership list (Excel format preferred):

Please provide contact details for the main contact person in your group.

The Main Contact email address is your organisation's address for notice as a member of Landcare Victoria Inc. As such, all important notices, opportunities and requests for information will be sent to the Main Contact. It is the responsibility of the nominated Main Contact to distribute information to other individuals in your organisation when relevant and appropriate.

Main Contact Name

First NameLast Name

Position in organisation (e.g. Secretary)

Postal Address (This may be a group-owned PO Box or office address, or the individual contact's own postal address)

Street Address

Street Address Line 2 (if required)

Town / SuburbState / Territory

Postcode

Mobile Phone

Please enter a valid phone number.Format: 0000 000 000.

Landline Phone

Please enter a valid phone number.Format: 00 0000 0000.

Email

example@example.com

Occasionally, Landcare Victoria receives requests from external organisations or prospective volunteers for member contact details (e.g. Main Contact or Facilitator email/phone number). We take privacy seriously and all such requests are handled at the discretion of Landcare Victoria Inc, only sharing details when we believe it is appropriate. See Privacy Policy.

If you would prefer your organisation's contact details are not shared under any circumstance, tick below:

Would your organisation prefer invoices to be issued to someone other than the nominated Main Contact?

If invoices should be sent to a separate Billing Contact, please provide their details below.

Billing Contact Name

First NameLast Name

Position in organisation. Include organisation name if invoices will be sent to a third-party organisation such as your group's parent Landcare Network or your local Council/Shire.

Billing Address (This may be a group-owned PO Box or office address, or the individual contact's own postal address)

Street Address

Street Address Line 2 (if required)

Town / SuburbState / Territory

Postcode

Mobile Phone

Please enter a valid phone number.Format: 0000 000 000.

Landline Phone

Please enter a valid phone number.Format: 00 0000 0000.

Email

example@example.com

All members must appoint a Delegate. Your Delegate is the individual who will represent your organisation at general meetings of Landcare Victoria Inc and hold your organisation's membership rights.

Delegate Name

First NameLast Name

Position in group (e.g. President)

Email

example@example.com

Delegate Address (This may be a group-owned PO Box or office address, or the individual contact's own postal address)

Street Address

Street Address Line 2 (if required)

Town / SuburbState / Territory

Postcode

Annual financial figures must be reported to Landcare Victoria in order to arrange insurance cover for your organisation and determine your membership fees.

Figures must be from a complete 12-month period and this must be the same period your organisation uses for other financial reporting purposes. That is, if your organisation prepares annual financial reports for the period 1 July to 30 June each year, use the same period when reporting to Landcare Victoria.

If your organisation has a different financial year, such as 1 January to 31 December, use that period instead.

Please report your organisation's figures from the financial year which ended in 2024.

Example 1: Your organisation uses the standard financial year for its annual reporting. Enter your figures from the period 1 July 2023 to 30 June 2024. If your organisation was not yet operating at this time and had no income/expenditure/assets, enter '$0' for each.

Example 2: Your organisation uses the calendar year for its annual reporting. Enter your figures from the period 1 January 2024 to 31 December 2024. If your organisation was not yet operating at this time and had no income/expenditure/assets, enter '$0' for each.

The organisation's financial year is 'each period of 12 months ending on...'

The reported financials are from the year ending on

e.g. 30/06/2024

Total Annual Income ($)

Total Annual Expenditure ($)

Total value of assets held at end of reporting year ($)

Include all funds held by the organisation (bank accounts, petty cash, term deposits), plus a rough value of any significant property owned at the end of the reporting period, such as vehicles/trailers, computers or land (small tools and equipment of low value may be omitted)

All types of activity conducted by the organisation must be reported to Landcare Victoria for insurance purposes. Please declare all activities your organisation has undertaken recently or is likely to undertake in the coming year.

Normal landcare activities:

Higher risk activities:

If your organisation conducts any activities that were not listed in the previous two questions, please describe them here:

Please tick to indicate your Delegate's understanding and agreement:

The organisation agrees to inform Landcare Victoria Inc of any facts or circumstances it becomes aware of which might afford valid grounds for future investigations, inquiries, regulatory proceedings, or other claims which may be covered under the Landcare Victoria Inc insurance package, and that if the organisation is currently aware of any such facts or circumstances, it has informed Landcare Victoria Inc or will do so immediately.

Your organisation's nominated Delegate must sign this section.

If you are the Delegate, you may sign manually on the left or upload your signature on the right.

If you are not the Delegate, you must confirm their agreement with the above declarations and get permission to upload their signature file.

Signature files may be in the following formats: jpg, jpeg, png, gif, bmp, pdf, doc, docx.

Signed by Delegate

Upload the Delegate's signature here

After submission your form will be reviewed and if any further information is required our team will be in touch. The application will then submitted to the Landcare Victoria Board for approval and an invoice will be issued for payment.

The timeframe for approval varies and may take several weeks, depending on the Board's schedule for meetings and out-of-session resolutions. Ensuring all information supplied in this form is complete and correct will help to reduce processing delays and ensure your application can be considered as soon as possible.

When you are ready to submit, please enter your email and click 'Submit'. A copy of your application will be sent to this email address.

Email

example@example.com

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Landcare Victoria Inc Membership Application 2025/26

FULL MEMBERSHIP

FEES & SUBSCRIPTION OPTIONS

PART 1A: APPLICANT ORGANISATION DETAILS

PART 1B: SUPPORTING DOCUMENTATION

PART 2A: CONTACT DETAILS

PART 2B: DELEGATE DETAILS

PART 3: FINANCIAL FIGURES

PART 4: ORGANISATIONAL ACTIVITIES

PART 5: DECLARATIONS

REVIEW AND SUBMIT