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Membership Application Form

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                                                                                                                             CCIAP is affiliated with
New Application              Renewal           Amendment

What type of membership you are applying for?
(Please refer to the explanatory note of each membership type at the back of this form).

     Financial Member:           Corporate Membership (A$200)                         Individual Membership (A$100)

     Associate Member: Corporate Membership (A$100)                                    Individual Regional        (A$30)
                                 Individual Membership (A$50)                         Individual Student          (A$10)
                                 Individual Academic          (A$50)
Applicants Name


Company Name (If applicable)


Trading Name (If applicable)


Postal Address
                                                                                                                 Post Code
Telephone number                         E-mail address                                              Facsmile number
 (    )                                                                                               (    )
Payment Details

     Visa           Mastercard           Bankcard       (Please fax completed form to: +61 7 32007531)
                                                                     Expiry date: _____/______ Amount: AU$ ________
 Card No: ______/_______/________/______

 Cardholder Name:                                                            Signature:


     Direct Debit (Please fax completed form to: +61 7 32007531)
     BSB. No.:     084-606                                                                  Account No.:         49254 9111

      Account      Chamber of Commerce and Industry Australia                                          For:      Membership Fee
       Name:       Philippines Inc

     Cheque: Please make cheque payable to CCIAP Inc and post cheque with completed form to:
             CCIAP Inc, P O Box 5164, Alexandra Hills, Queensland, Australia 4161

Sponsorship Details
Note: New members must be sponsored by at least one financial member of CCIAP Inc and seconded by
another financial member.
Sponsor name                                              Signature                                       Date


Seconded by                                                Signature                                      Date

Privacy Disclaimer: CCIAP Inc. collects information on this form to manage its membership register. This information may be released by
CCIAP Inc to other parties for the purposes of direct business and trade leads and referrals. The information is accessible by authorised
Executive Committee Members and your personal information will not be released to other third parties without your consent unless
authorised to do so by law.

                             Website: www.cciap.org.au ƒ                 Email: secretary@cciap.org
Membership Application Form
Explanatory Notes (In accordance with CCIAP’s Constitution and By-laws)
                                Membership Types and Annual Fees

Four types of membership

Financial members (with voting privileges)              Associate members (without voting privileges)
•   Corporate membership: A$200 p.a.                    •   Corporate membership: A$100 p.a.
•   Individual membership: A$100 p.a.                   •   Individual membership: A$50 p.a.
                                                        •   Individual Regional: A$50 p.a.
                                                        •   Individual Academic: A$30 p.a.
                                                        •   Individual Student: A$10 p.a.

Affiliate Members                                       Honorary Members
•    Applicable fees: None                              •  Applicable fees: None
•    Voting privileges: None                            •  Voting privileges: None


                                 Membership Terms and Conditions

Sponsorship
New members must be sponsored by at least one financial member of CCIAP Inc and be seconded by another
financial member.
Financial members
•   Financial members are entitled to vote and enjoy all other membership privileges.
•   Financial member with a corporate membership are allowed a maximum of 3 people; with only vote allowed.
•   Financial member with an individual membership is allowed one vote.
Associate members
•  Associate members enjoy membership privileges except voting rights.
    Corporate membership:
      -  Associate members with a corporate membership are allowed a maximum of 3 people.
    Individual Regional membership:
      -    An Individual Regional member is defined as one who resides outside Southeast Queensland which
           includes Beaudesert, Boonah, Brisbane City, Caboolture, Caloundra City, Cooloola, Gold Coast City,
           Ipswich City, Kilcoy, Logan City, Maroochy, Noosa, Pine Rivers, Redcliffe City and Redland.
Affiliate membership
Affiliate members are members of organizations or clubs who enjoy reciprocal membership privileges without the
obligation of paying membership fees except the right to vote.
Honourary Membership
Honourary membership is bestowed to individuals by Executive Committee decision who have rendered
outstanding and exceptional service to the Chamber. Honourary members enjoy the privileges of an Associate
Member without the obligation of paying the annual membership fees.
General
•  Membership is for one year commencing in July up to June the following year.
•  Membership renewed within 2 months of expiry date (to Aug 31) will be considered a RENEWAL.
•  Membership renewed after 2 months of expiry date (from Sept 1) will be considered as a NEW
   APPLICATION and is subject to new membership application approval.
•  Membership fee paid by NEW APPLICANTS shall be pro rated for the current and the following year.
•  Members are subject to the Chamber’s Constitution, Policies and Rules.

				
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Description: Membership Application Form