APPLICATION FOR INDIVIDUAL MEMBERSHIP
Membership Details Form
Name:
*
First Name
Surname
Website (if applicable):
Contact Details
Mobile Number:
*
-
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E-mail:
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example@example.com
Postal Address:
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Street Address
Street Address Line 2
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Briefly outline your professional interest in being a member of the IDCC
*
Membership Fee
Member Type
Annual Fee
GST
Total Payable Fee
Individual
(Ordinary Regular Member)
$200
$20
$220
Individual
(Enhance Regular Member)
$400
$40
$440
Select Membership Category
*
Individual (Ordinary Regular Member)
Individual (Enhance Regular Member)
Method of Payment
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EFT (Bank details will be sent on submission of form)
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