Application for

SMCBA Membership

SMCBA Membership is for 1 year from confirmation of payment.  All credit card payments on the SMCBA website are processed by eWay payment gateway.  We accept VISA, Mastercard and Amex.

MEMBERSHIP OPTIONS
SMCBA MEMBERSHIP FOR: * 
A. Small Global Corporate: 25 or Less full time employees ($300 plus Joining Fee $75 plus GST*)  
B. Medium Global Corporate: 26 to 100 full time employees ($500 plus Joining Fee $125 plus GST*)  
C. Large Global Corporate: Over 100 full time employees ($1,000 plus Joining Fee $250 + GST*)  
D. Large Corporate Site/Division: for companies with over 100 full time employees requiring membership for one site only. ($500 plus Joining Fee $125 + GST*) Site membership applies only to the one site/division nominated on this form  
E. Educational Institution/Government Department (site only) ($300, Joining Fee $75 plus GST*)  
F. Individual ($125 plus GST*, No Joining Fee, not transferable)  
G. Student ($50 plus GST*, No Joining Fee, not transferable)  

ORGANISATION, PRIMARY CONTACT & BILLING INFO
First Name: * 
Last Name: * 
Organization: * 
Position:
Address: * 
Address 2:
City: * 
State:
Postcode: * 
Country: * 
Phone: * 
Fax:
Email: * 
Confirm Email: * 

VOTING MEMBERS:

Voting representatives: categories F and G – one vote; categories A and E – 3 voting members;categories B and D – 5 voting members, category C – 10 voting members

The representatives nominated are deemed to hold nomination/voting rights.
Please provide Name, Position and Email Address of each voting member.:

EMPLOYEES TO RECEIVE SMCBA INFORMATION:

There is no limit to the number of nominated representatives that can be listed to receive SMCBA information.
Please provide Name, Position and Email Address of each member to receive SMCBA information::