MBNT New Membership Application Form

Master Builders NT

Membership Application Form

Please ensure you have all documents ready to complete your application.
- Insurance documents
- References
- Trade licences
- Director information
Please complete and submit this form to apply for membership. One of our memebrship team will be in touch once submission has been made.

Membership Application Form
Member Information

Please complete all fields
Business Trading Name *
Business Entity Name*
(As shown on ABN registration)
ABN*
ACN*
Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
Postal Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Industry AdvocacyHR SupportBuilding ContractsEventsMember BenefitsNetworkingLicencingMaster Builders InsuranceOther
How did you hear about us?*
Have you been a previous member?*
If yes, what was your member number?
Number of employees*
Website URL*
Facebook URL
Linked In URL

Owners, Directors & Business Partners

Please indicate who has authority to vote on behalf of the company at our AGM or special general meetings.
Owner*

First NameLast Name
Position*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
YesNo
YesNo
Other Director or Business Partner

First NameLast Name
Position
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
YesNo
YesNo

Contacts
Primary Contact *

First NameLast Name
Position*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Accounts Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
YesNo
YesNo
If Yes, please list name and contact details below.

References

Relevant to the building and construction industry. Please ensure your referees have been contacted prior to us getting in touch.
Reference 1
Company*
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Reference 2
Company
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com

Membership Category

Please choose from the following industry category options below that bests suits your primary business
Retired MemberAssociate MemberTrade Supplier / ManufacturerTrade Contractor - DomesticTrade Contractor - CommercialResidential BuilderCommercial Builder
If a Trade Contractor, please advise which trade. Eg: Plumbing, Electrical, Concreting, Painting, Roofing ect

Privacy Statement
Master Builders NT respects your privacy and is committed to protecting the personal information collected as per our Privacy and Data Collection Policy. You may have access to the information, provide changes to contact details or opt-out of receiving direct marketing activity at any time by contacting the MBNT office by phone on (08) 8922 9666 or email info@mbant.com.au

I/we authorise Master Builders NT to make any enquiries deemed necessary to qualify my application.

I/we undertake, if accepted as a Member of Master Builders NT, to abide by the Master Builders NT Membership Code of Conduct.

Consent to Share Data
I/we understand that MBNT will manage my information in accordance with its Privacy Policy, and that I may access or update my personal information, or withdraw consent to share certain data, by contacting MBNT at any time.

By signing this form, I/we acknowledge and consent to Master Builders Northern Territory (MBNT):

• Collecting, storing, and using my personal and business information for the purposes of administering my membership, providing member services, and communicating with me.

• Sharing relevant information with third parties where reasonably necessary to deliver member benefits (such as training providers, event organisers, sponsors, insurers, or government agencies), subject to appropriate privacy safeguards.

• Using my contact details to send me information about MBNT programs, industry updates, advocacy, and events, unless I choose to opt out of marketing communications.

•Including my name, business name, and contact details in MBNT’s membership directory (available to members only), unless I notify MBNT in writing that I do not wish to be included.
YesNo

Acknowledgement
By completing this MBNT Membership Application and signing, I agree to the following terms & conditions:
1. Advise Master Builders NT of any changes to my business activities, that may affect the membership category granted or any of the other information supplied on this form.
2. As a member, I shall abide by the MBNT Membership Code of Conduct
3. I authorise MBNT to make my/our business name & Logo available on the MBNT member online directory.
YesNo
Name

First NameLast Name
Position
Signature of authorised company representative*

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Master Builders NT

Membership Application Form

Please ensure you have all documents ready to complete your application.

Membership Application Form

Member Information

About your business

Licencing

Insurance

Trades and Services

Owners, Directors & Business Partners

Contacts

References

Membership Category

Membership Subscription Fees

Payment

Privacy Statement

Acknowledgement