Membership Application Form

Name

First NameLast Name

E-mail

Membership

Professional$350.00 AUD

Years

Associate$350.00 AUD

Years

Community$95.00 AUD

Years

StudentFree

Years

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Total $0.00 AUD

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

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)

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