Membership Application Form

SECTION 1 Must be completed by new applicants. Optional Section for change in particulars of existing members.

Surname:		Given Names:
Occupation:
Employment Status: (please tick)	Employee Self-Employed
If Self-Employed, Trading / Association name:
Position / Title:
Phone (Home):		Phone (Work):
Facsimilie (Home):		Facsimilie (Work):
Mobile:		Email:
Address:		Post Code:

Details of Relevant Arboricultural Experience / Activities / Interests / Etc: (Include all areas of specialisation and practical experience in as much detail as you like)


Details of Relevant Qualifications / Training / Seminars / Etc: (Include name and address of Institution, date of awards etc)


Details of Insurance: Include name of Insurer, policy type's and date of coverage:

SECTION 2 Must be completed by new applicants - option section for existing members.
NEW APPLICANT
Membership Category:
Joining Fee:
Annual Fee:
Total:
EXISTING MEMBER
Membership Category:
Annual Fee Renewal:
Total:
Please calculate the correct amount from the below table, fill in the appropriate section, and submit this form.

FEE SCHEDULE Must be completed by new applicants - option section for existing members.
Membership Category	Joining Fee	Annual Fee
Student	NIL	$110.00
Corresponding	$44.00	$79.00
General	$44.00	$195.00
Insurance	$44.00	$240.00
Corporate 1 to 5	NIL	$330.00
Corporate 6 to 10	NIL	$660.00