MEMBERSHIP APPLICATION FORM • Licenced Septic Tank Manufacturers by lindayy

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MEMBERSHIP APPLICATION FORM • Licenced Septic Tank Manufacturers ...

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									                375 WICKHAM TERRACE, BRISBANE, QUEENSLAND 4000
                        Tel : (07) 3842 2228 Fax : (07) 3013 3420
                       Email : info@wastewaterpractitioners.com.au



                   MEMBERSHIP APPLICATION FORM

Company :                      ________________________________________

Address :                      ________________________________________

                               ________________________________________

                               ________________________________________

Company Representative :       ________________________________________

Representative’s Mobile :      ________________________________________

Telephone :                    ________________________________________

Facsimile :                    ________________________________________

Email :                        ________________________________________


      Full Membership :        $1,100 per annum (inclusive of GST)

      Associate Membership :   $110 per annum (inclusive of GST)

                               •   Licenced Septic Tank Manufacturers   □
                               •   Service Persons                      □
                               •   Site and Soil Evaluators             □
                               •   Shire/Local Councils                 □
                                      (Please tick appropriate box)

      Supplier Membership :    $550 per annum (inclusive of GST)

								
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