Membership Application Form

Membership Application

Macedon and Mount Macedon Community House Inc. ABN: 50871098274
Name*

Given Name Last Name
Business/Organisation Name
If applicable
Address*

Street Address

Street Address Line 2

Town State / Province

Post Code
Postal Address*
If different from above
E-mail*
example@example.com
Phone Number

Area Code Phone Number
In order to become a member of Macedon and Mount Macedon Community House Inc. applicants must agree to support the purposes of the organisation and agree to abide by the rules of the organisation:

Please indicate your agreement by checking the two statements below:
*

I support the mission and purposes of the organisation (as linked above)
*

I agree to abide by the model rules adopted by Macedon and Mount Macedon Community House Inc (as linked above)
Signature*

Clear
Signature Date

MonthDay Year
Date
ANNUAL MEMBERSHIP SUBSCRIPTION
Fees have been waived for all new members joining in 2021. Notification of the annual membership subscription fees for new and renewing members in 2022 will be made following the inaugural AGM in Dec 2021.
Type of membership (please pick one)*

IndividualFamilyBusiness/Organisation
Business/Organisation name: if applicable
Please verify that you are human*
The Committee of Management will consider applications for membership as soon as practicable after their receipt and resolve to accept or reject an application. Applicants will promptly be notified in writing of the outcome.

Your information will be held by the Committee of Management in strict confidence and will not be shared with any third parties.

Hard copies of the membership form can also be obtained from Macedon Newsagency, Macedon IGA & Mount Macedon Trading Post
Should be Empty: