Membership Application Form

Print out the page, complete the form and post to:
Essential Oil Producers Association of Australia
22 Canterbury Chase
Goonellabah NSW 2480
Telephone: +61 2 6624 2453
E-mail: southwells@optusnet.com.au
 

Application for Membership Payment Methods: 1. Please find enclosed a cheque for $ ...................(made payable to EOPAA)* 2. Payment can be made by EFT: Account Name: Essential Oil Producers Association of Australia; BSB No. 082 726; Account Number: 634 480 965 Tick one Full Membership - $1000  p.a. (Producers of essential oils, plant extracts and producers of plant  material for the production of essential oils and plant extracts)  Associate Membership (Institute/Individual) - $150  p.a. (Non-commercial institutes, researchers and other parties) Note:  Only Full Members have voting rights FULL  NAME    Mr/Mrs/Ms (circle one)           ......................    ....................                                                                  First name             Surname TITLE    ...............................                   COMPANY ........................... ADDRESS ........................................................................................... STATE ...................    POSTCODE ................ TELEPHONE  (...)....................... FAX (...)......................... MOBILE ........................ EMAIL ................................. Signed ..............................        Date ................. * Do not include a cheque at this point unless you are applying for Associate Membership. Note: EOPAA is not registered for GST; accordingly no GST is included.