Student Membership of AUUG Inc.

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

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

• If paying for your membership with a credit card, the invoice may be faxed to AUUG Inc. on +61 2 8824 9522.
• 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.
  • If you require correspondence to be sent by air mail, there is a $60.00 surcharge.
• If you have any queries, please call the AUUG Secretariat on +61 2 8824 9511 or freephone 1800 625 655.

Section A: Personal Details

Surname:      _______________________  First Name: ___________________________

Title:        _______________________  Position:   ___________________________

Organisation: ________________________________________________________________

Address:      ________________________________________________________________

Suburb:       __________________________  State: ________  Postcode: _________

Telephone:    Business: ________________  Private: ___________________________

Facsimile:    __________________________  E-mail:  ___________________________

Section B: Price

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

^* Delete as appropriate.
^** Please complete Section C.
GST only applies to students in Australia. Rates valid from 1st July 2000.

Section C: Student Member Certification

For those applying for Student Membership, it is required that this section be completed by a member of the academic staff.

I hereby certify that the applicant on this form is a full time student and that the following details are correct.

Name of Student:  _______________________________________________________

Institution:  ___________________________________________________________

Student Number:  ________________________________________________________

Signed:  ________________________________________________________________

Name:  __________________________________________________________________

Title:  _________________________________________________________________

Date:  __________________________________________________________________

Section D: 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 E: 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

Name on Card:  _________________________________________________________

Card Number:  __________________________________________________________

Expiry Date:  __________________________________________________________

Signature:  ____________________________________________________________

Section F: 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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