"
*
" indicates required fields
Full Name
*
First
Last
Company/Business Name
*
ABN
*
Address
*
Street Address
City
Post Code
Will the person entered above be the nominated representative?
Yes
No
Name of Nominated Representative
First
Last
Membership Application Consent
*
I consent
In the advent of my admission as a member, I agree to be bound by the rules of the
association for the time being in force. I acknowledge that the annual membership fee is
$45 which falls due on receipt of an invoice. Bank Account details BSB: 650000
Account No. 527674706
Business NSW Alliance Program Consent
I consent
You agree to become a member of Business NSW within the Local Chamber membership class) and be bound by the Business NSW Constitution which is published at https://www.businessnsw.com/content/dam/nswbc/businessnsw/pdf/nsw-business-chamber-constitution.pdf, the Business SW Membership Terms and Conditions which are published at www.businessaustralia.com/membership-terms-and-conditions and the Business SW Privacy Policy which is published at www.businessaustralia.com/privacy-policy.
Please Note: If you are already a member of Business NW in a membership class other than the Local Chamber membership class and would like to move to the Local Chamber membership class, then you must first resign your existing membership
Nominee Contact Details
Email
*
Phone Number
*
Is your postal address different to your business address above?
Yes
No
Address
Street Address
City
State
Post Code
Date of Birth
DD slash MM slash YYYY
Skills/talents that may help the Adamstown Business Group
Email
This field is for validation purposes and should be left unchanged.
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