MEMBERSHIP APPLICATION FORM
THE INVENTORS ASSOCIATION OF AUSTRALIA (VICTORIA) INCORPORATED
NEW OR RENEWAL
To: Hon Treasurer
30 Reids Lane
Warranwood
Victoria 3134
Australia
- I wish to become a new member ›
- renew my membership ›
I agree to be bound by the articles of the association.
Title/First Name:______________________________________
Surname:___________________________________________
Address:____________________________________________
___________________________________________________
Phone:______________________________
Occupation:_________________________________________________
MEMBERSHIP FEES
› Joining Subscription plus First Years Membership $200
› Renewal Subscription $80
› Corporate Subscription $350
I enclose my Cheque No___________ for $__________
Signature:_________________________
Date:_____________________________
Please provide an engraved name tag with the following title printed
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