AJSQ Membership Application or Renewal Please fill in the following fields with required contact information. All fields are required to process application Your title Dr.Mr.Mrs.Ms.Other First name Surname Organisation (for Corporate/School members) Street number and name Suburb Postcode Contact phone number Your email Membership Type/Fee (please select) Corporate – $275.00Individual – $35Family – $40.00School- $100.00 How did you find out about us? Internet searchIntroduction from a current memberSocial mediaEvent attendanceOther (please specify in Comments section below Comments Payment Options: 1/ deposit under email advice to AJS Bank account at: BSB: 014002 | Account: 253034524 2/ to pay via credit card, please call Taeko on 07 3292 7619 ( please do not email credit card details). Please select payment method: pay by credit card by phone calldirect deposit to bank account Following payment we will contact you to confirm your membership. (Please note: The AJSQ is a registered not-for-profit organisation and not registered for GST) Note: If you are a Full Time tertiary student, contact us regarding ‘Student Registrant’ status. Δ
