Ordinary Membership of AUUG Inc.


Application & Tax Invoice
AUUG Incorporated - ABN 15 645 981 718


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

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

AUUG Incorporated
PO Box 7071
Baulkham Hills BC    NSW    2153
AUSTRALIA

Section A: Personal Details

Surname:      _______________________  First Name: ___________________________

Title:        _______________________  Position:   ___________________________

Organisation: ________________________________________________________________

Address:      ________________________________________________________________

Suburb:       __________________________  State: ________  Postcode: _________

Telephone:    Business: ________________  Private: ___________________________

Facsimile:    __________________________  E-mail:  ___________________________

Section B: Prices

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

Renew/New* Ordinary Membership
 
$125.00 (including $11.36 GST)
Surcharge for International Air Mail
 
$60.00

* Delete as appropriate.
GST only applies to Australian institutions. 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:

 
Yes
 
No

Section D: Payment

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.

Please do not send purchase orders.

OR

Pay by credit card

 
Please debit my credit card for A$____________
 
Visa
 
Mastercard
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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