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>> Membership Application
To download a PDF application form,
click here.
The Australian Society for Progress & Wellbeing Application Form
Title
*
Mr
Mrs
Miss
Ms
Other
If Other please specify:
*
Name
*
First
Last
Company
*
Job Position
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Phone Number
*
Membership Type
*
Supporter (free of charge)
Individual $285 (for 2 years)
Small Business less than 100 staff $1999 for up to 10 members
Medium Business 100-1000 staff $3999 for up to 25 members
Large Business more than 1000 staff $7499 for up to 50 members
Payment Details
BANK:
ACCOUNT NAME:
BSB:
ACCOUNT NUMBER:
National Australia Bank Ltd
Australian Society for Progress & Wellbeing
083 088
84615 3502
Check List
*
Payment will be made within 24 hours by direct debit to the bank account detailed above.
I understand The Australian Society For Progress & Wellbeing (The Society) deals with personal information in accordance with the Privacy Act 1988 (Cth).
I understand I can access a complete copy of the Privacy Policy by contacting info@aspw.asn.au
I agree to The Society sending me updates and information via email about The Society events and activities.
I have read and understand the Privacy Policy of The Society, available at the foot of this page.
Submit
