Membership Application Form

Name*

First NameLast Name

E-mail*

Membership*

Professional$350.00AUD

Years

Associate$350.00AUD

Years

Community$95.00AUD

Years

Student$ FreeAUD

Years

Enter coupon

Total $0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

The ACNEM Cancellation and Refund Policy is as follows:
Membership that is cancelled within 7 days of registration will receive a full refund
Membership cancelled after this time, will be subject to:
o A $50 administrative fee.
o A refund on a pro rata basis – i.e. only for time not already lapsed.
The refund and cancellation policy will not be waived.
Membership may not be transferred to another individual.

Currency: Pricing is in Australian Dollars ($AUD) and inclusive of GST.
Security: All form information submitted will be protected by 128/256 bit encryption Secure Sockets Layer (SSL)