Membership Application

Membership Application

 Application for  Membership

 

Wentworth Falls Chamber of Commerce and Community Inc.

[incorporated under the Associations Incorporation Act 2009]

I,________________________________________________________________________

[full name of applicant]

Representing    ____________________________________        ____________________

[business name for Business Membership]                      [A.B.N.]

Of                     ____________________________________________________________

[address]

Contact details:     _____________     ________________       _______________________

[telephone]                    [mobile]                             [e-mail]

hereby apply to become a  Business / Community  [cross out one]  Member of the Wentworth Falls Chamber of Commerce and Community Inc.  I agree to be bound by the Constitution of the association and with the Policies and Procedures in place.

____________________________________                        ___________________
            [Signature of applicant]                                                                        [Date]

 

Do you wish to receive regular communications from the Chamber by e-mail?        ________

Do you wish to have your business listed on the Chamberís website?, www.wentworthfalls.org.au        ________

 

Business Member annual fee is $110.     

Community Member annual fee is $25

Please either attach a cheque payable to W.F.C.C.C. or make your payment by direct deposit to our account:

 

BSB:             633-000          (Bendigo Bank, Katoomba)

Account:       1480-64439    (Wentworth Falls Chamber of Commerce and Community)

 

Please return this Application and your first year membership subscription by cheque [    ] or direct deposit  [    ]  [please indicate]  to:

                                    The Secretary

Wentworth Falls Chamber of Commerce and Community

PO Box  51,  Wentworth Falls,  NSW,  2782

 

Nominated by:    _____________________________  Date:  ____________

 

Seconded by:     _____________________________  Date:   ____________

 

New membership number:    ________        Date registered:   ____________

 
 

 

 

 

 


[Administration only]


Address: President
PO Box 51
Wentworth Falls NSW 2782
Email Address: