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JOIN AS MEMBER

To apply as a Member, you will need to complete the three forms listed below:

General Application Form
Member Capability Survey
Member Training Survey

This information will provide EMICoL with a profile of your organisation, your company’s capabilities and cooperative initiatives such as training requirements and may be used to identify other initiatives that will be developed from time to time.

GENERAL APPLICATION FORM - Member

ORGANISATION NAME:

ABN:
ACN:

PRIMARY CONTACT
First Name:
Surname:
Title:
Phone (Office):
Phone (Mobile):
Fax:
Email:

SECONDARY CONTACT
First Name:
Surname:
Title:
Phone (Office):
Phone (Mobile):
Fax:
Email:

POSTAL ADDRESS
Same As Above
Street:
Suburb: State:
Post Code:

Description of your Business:

"Please note that this information will be used for your online presence on the
EMICoL website and any marketing material"

**ENTITLEMENTS**
Entitlement	Description	Cost
Membership	Network with Cooperative Members, Suppliers and Sponsors	$440 (including GST) Annual fee based on financial year
Full Voting Rights	Participate in Managing EMICoL
Subsidised attendance at EMICoL events	Seminars, Training, Guest Speakers
Benefit from group activities	Opportunity to participate in group tendering and member discounts
Portfolio Management	Assist Directors in area of interest
Holding Shares in EMICoL	Ownership	$100 (GST exempt) First year only
	TOTAL	$

PAYMENT: An invoice will be issued for payment on approval of your application.

INVOICE TO BE FORWARDED TO:
Organisation Name:
Attention:
Address:
Suburb: State: Post Code:

Yes, I am authorised to apply to be a Member

Once your application has been considered by the Board of Directors, your nominated primary contact person will be notified in writing by mail.