APPLICATION FOR MEMBERSHIP
2017
To become a member of Southern Strength Agile Manufacturing Network,
please complete the form below and fax/email back to:
[email protected] or FAX 9525 3431
Contact Name:
Position:
Email:
Years of
Operation:
Company Name:
ABN:
Brief Company
Description:
Company
Turnover
(tick applicable)
Company
Address:
Number of
employees:
Company Mailing
Address:
$1 Million $5 Million
< $1 Million
Full time:
Part Time:
Phone:
W:
Fax:
Company Website:
>$5 Million
Casual:
M:
Please choose from the following membership options:
Standard membership renewal – no increase in 2017 - $275 (exc GST)
Membership renewal- including free attendance for 1 member to all network meetings, site visits and
Christmas function. $400 (exc GST) a saving of up to $155
Membership renewal- including free attendance for 1 member and a guest to all network meetings, site
visits and Christmas function. $525 (exc GST) a saving of up to $310!
Payment Method:
Direct Deposit
Southern Strength, NAB BSB 082-367, Account number 11-509-4043
If paying by Direct Deposit please use your company name as reference when processing the payment
Southern Strength Privacy Policy: Personal information is collected to process payments, issue tax receipts; send updates on Southern Strength
events/news/opportunities. Southern Strength does not pass on your personal information onto any other organisations