APPLICATION FOR MEMBERSHIP
Please type in the text boxes, print the document by clicking the "print" button at the bottom of the form then sign and date the applicable fields.
I (given names then surname) Of (Private address including postcode)
hereby apply for membership of the Gold Coast Marine Industry Association Inc. (‘the Association’)
I declare that I am not aware of any reason why I should not be considered a fit and proper person to be eligible for membership of the Association.
If membership of the Association is granted to me, I agree to be governed by its Rules (Dep’t of Fair Trading Model Rules for an Association) and the Association’s Membership Eligibility Requirements as determined from time to time. I further agree to promote the objects of the Association.
Should I wish to resign my membership, I agree to notify my intention in writing and shall pay all liabilities owed by me to the Association before such resignation is accepted, and I further undertake to return any Certificate of Membership awarded to me.
Applicants Signature:............................................................
Date:........................
PROPOSER’S DECLARATION To the President of the Gold Coast Marine Industry Association Inc.,
I declare that I have known the applicant for ............ years/months and certify that to the best of my knowledge, the information contained in this application is true. I propose the applicant for membership of the Gold Coast Marine Industry Association Inc.
Proposers Name:...................................................................
Proposers Signature:..............................................................
SECONDER’S DECLARATION I certify that the applicant for membership of the Gold Coast Marine Industry Association Inc has been known to me for a period of ............ years/months and I second his/her application for membership.
Seconder's Name:................................................................
Seconder's Signature:...........................................................
Please contact the Association’s secretariat if you require any assistance with nominees or seconders for this application.
APPLICANT'S BUSINESS DETAILS
Registered Business name ABN Details Applicants Business title Number of Employees Business Street Address Business Postal Address Nature of Business Operations Business Phone Number Mobile Phone Number Fax Business Email Address Business Website Address
Please indicate address to be used for correspondence: Street Postal
APPLICANTS PERSONAL DETAILS
Contact Details
Home Phone Number Mobile Phone Number Home Fax Number Home Email Address Date of Birth (optional) Place of Birth
APPLICATION FEE: $100 MEMBERSHIP FEES: Associate Member $100 p.a. (No voting rights) or Full Member $150 p.a. (Full voting rights)
MEMBERSHIP APPROVAL
Having complied with the criteria for membership of the Gold Coast Marine Industry Association Inc and having agreed to abide by the Association’s rules and paid the required Membership Subscription fee,
............................................................is hereby admitted as a Member of the Gold Coast Marine Industry Association Inc
Presidents Name:.................................................................
Date:..............................
Proposers Name:..................................................................
Please return your Application Form together with your cheque for the appropriate Membership Fee to:
The Secretary Gold Coast Marine Industry Association Inc P.O. Box 166 BOND UNIVERSITY, QLD 4229