Corporate Membership Form - DOC

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Corporate Membership Form - DOC Powered By Docstoc
					                                  Green Collect Membership

Membership Form
Name of organisation:

Address of organisation:

Date:                                                             Number of floors occupied:

Number of employees located at above address:
Number of collection bins required:


Details of contact person:                                        Details of secondary contact person:
Name:                                                             Name:

Phone:                                                            Phone:

Email:                                                            Email:

Fax:                                                              Fax:




Please select from the following options (all are GST inclusive):


       Corporate Membership – annual service fee $1,200
               Additional Site – annual service fee $ 440 (Additional Form will need to be filled out)
       Schools Membership – annual service fee $1,200
       Small Business Membership – annual service fee $ 300
       Community Group Membership – annual service fee $ 200


       Additional Donation $_______________ (Donations to Green Collect are tax deductible)


       Electronic Funds Transfer              BSB: 633 000        Account: 124 098 971
       Cheque payable to Green Collect

Please note, a quarterly per kilogram service fee for units collected will be charged in addition to the annual
membership above.


PLEASE COMPLETE THIS FORM AND FAX TO 9650 7936, OR EMAIL TO
memberships@greencollect.org

If you would like to support the work of Green Collect, Donations above $2 are Tax Deductible
Level 7, 174 Collins Street Melbourne VIC 3000                                                Green Collect Limited
Phone: 03 9663 8843          Fax: 03 9650 7936                                                ABN 68 112 489 684
Email: contactus@greencollect.org
www.greencollect.org
                                  Green Collect Membership

Membership Feedback
We would appreciate any feedback about your membership or improvements for your continued
membership. Please complete the attached form with your comments and return it to the address listed
below.
We would like to include your organisation logo on our member page. Please confirm your acceptance of
this below.

Organisation Name___________________________

                                                          High Importance                  Low Importance
How highly does your company rate its
contribution to:
The job and income security of those finding                  1         2          3          4           5
new employment with Green Collect
Reduction of waste to landfill                                1         2          3          4           5

Developing a network of organisations                         1         2          3          4           5
committed to improving the social and
environmental well being of our city.
Does your organisation publicly report on                 □   Yes
environmental or sustainability
performance?                                              □   No
Which other services offered by Green                     □   Waste/Paper Assessment
Collect would you be interested in
exploring?                                                □   Sustainable Purchasing Program
                                                          □   Green Office Services
                                                          □   Other , please specify
What other products would your
organisation like to see recycled?

Do you have further feedback for Green
Collect?

WEBSITE
□   Green Collect has permission to display our organisation logo on the Green Collect website
    www.greencollect.org to indicate that our organisation is a Green Collect Member.
□   Green Collect has permission to display our organisation logo on Green Collect promotional material to
    indicate that our organisation is a Green Collect Member.

Please tick your acceptance and sign here:              Name: ______________________________

________________________________                        ___________________________                     __________
Signature                                               Position                                        Date

Please complete this form and fax to 9650 7936 or email relevant information to contactus@greencollect.org


If you would like to support the work of Green Collect, Donations above $2 are Tax Deductible
Level 7, 174 Collins Street Melbourne VIC 3000                                                Green Collect Limited
Phone: 03 9663 8843          Fax: 03 9650 7936                                                ABN 68 112 489 684
Email: contactus@greencollect.org
www.greencollect.org