Membership Registration

Networker's Details
Title: *  
First Name: *  
Last Name: *  
Position Held: *  
Organisation: *  
Postal Address: *  
Suburb: *  
State: *
  Postcode:

How many employees does your organisation have?

Provide 10 key words that best describe your
product or services (for our website search
facility)

Please Provide a 20 word description of your business for the website.

Choose your membership level - click here for full details on membership benefits. All prices shown include GST.
Individual $ 80.00
Micro Business (< 5 employees) $ 150.00
SME (6 to 49 employees) $ 290.00
Association/Traders Groups $ 350.00
Not-for-profit Corporate $ 400.00
Corporate (50+ employees) $ 580.00
Contact Details
Telephone: *  
Mobile:
Facsimile:
Email:  
Web Site Address:
Comments:
Once you have completed this form you will be issued with a tax invoice for your membership payment.
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