Institutional Membership of AUUG Inc.

Use this invoice to apply for, or renew, institutional membership of AUUG Inc. A different form should be used to apply for ordinary membership, student membership or a newsletter subscription.

To apply for institutional membership of AUUG Incorporated, please print out this invoice, complete it, and return it to:

• Please do not send purchase orders -- payment must accompany this invoice.
• Foreign applicants:
  • Please note that all amounts quoted are in Australian Dollars.
  • Please send a bank draft drawn on an Australian bank, or credit card authorisation.

Section A: Member Details

The primary contact holds the voting rights for this institutional member, and two designated representatives (one of whom may the the primary contact) will be given membership rates to AUUG activities including chapter activities. In addition to the two representatives, additional representatives can be added at a cost of $100 each (including GST).

NAME OF ORGANISATION:  _______________________________________________________

Primary Contact:

Surname: _______________________ First Name:  ___________________________

Title:        _______________________  Position:   ___________________________

Address:      ________________________________________________________________

Suburb:       __________________________  State: ________  Postcode: _________

Telephone:    Business: ________________  Private: ___________________________

Facsimile:    __________________________  E-mail:  ___________________________

Representative 1:

Surname:      _______________________  First Name: ___________________________

Title:        _______________________  Position:   ___________________________

Address:      ________________________________________________________________

Suburb:       __________________________  State: ________  Postcode: _________

Telephone:    Business: ________________  Private: ___________________________

Facsimile:    __________________________  E-mail:  ___________________________

Representative 2:

Surname:      _______________________  First Name: ___________________________

Title:        _______________________  Position:   ___________________________

Address:      ________________________________________________________________

Suburb:       __________________________  State: ________  Postcode: _________

Telephone:    Business: ________________  Private: ___________________________

Facsimile:    __________________________  E-mail:  ___________________________

Please attach a seperate sheet with details of any additional representatives.

Section B: Price

Please tick the box to apply for institutional membership. Please indicate if international air mail is required.

^* Delete as appropriate.
GST only applies to institutions in Australia. Rates valid from 1st July 2000.

Section C: Mailing Lists

AUUG mailing lists are sometimes made available to vendors. Please indicate whether you wish your name to be included on these lists:

Section D: Payment

Please do not send purchase orders. Payment is required with this invoice.

Pay by cheque

Cheques to be made payable to AUUG Inc. Payment in Australian Dollars only.

For all overseas applications, a bank draft on an Australian bank is required.

OR

Pay by credit card

Name on Card:  _________________________________________________________

Card Number:  __________________________________________________________

Expiry Date:  __________________________________________________________

Signature:  ____________________________________________________________

Section E: Agreement

I agree that this membership will be subject to rules and bylaws of AUUG as in force from time to time, and this membership will run from the time of joining/renewal for 12 months.

Signed:  _______________________________________________________________

AUUG Secretariat Use Only

Chq: bank _________ bsb _____-_____ a/c ________________ # _________________

Date: ________   $     CC type ___ V# ____________

Who: ______________                      Member# __________

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