Association Membership Application

Association Membership

Application and Renewal
Member Name*

First NameMiddle Name (optional)Last Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Member E-mail*
example@example.com
Mobile Number*
Phone Number
Member's Interest*
Membership Status*
I have read and agree to the Association Membership Terms and Conditions as outlined on the Belonging Matters website.
I understand that I am joining as an individual person, not as an organisation.
My Products
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New Association Member
Select this option if you are joining as a new member, or rejoining after an extended break.

$20.00AUD Quantity

Renewing Membership
Select this option if your membership is about to expire and you are wishing to renew.

$10.00AUD Quantity

Subtotal

$0.00AUD

Tax

$0.00AUD

Total

$0.00AUD

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.