Organisation Details

Organisation Name(required)

Organisation Country(required)

Number of Employees:
Number of students (if applicable):
Please invoice:

Applicant Details

Applicant Name(required)

Applicant Role(required)

Applicant Country(required)

Your Email (required)

Your Phone:

Mailing Address:

Application Type:

—Please choose an option—Tertiary Membership - Band 1 - Less and 15,000 Students - $2,400Tertiary Membership - Band 2 - Between 15,001 and 24,999 students - $4,200Tertiary Membership - Band 3 - Over 25,000 students - $6,100Associate Member - Business/Industry/Government - $2,400Associate Member - Individuals (Including students, academics and professional staff) - $300

Additional Contact Person

Are you the main point of contact for Engagement within your organisation? If not, please add an additional contact.

Additional Contact Name(required)

Additional Contact Role(required)

Additional Contact Email (required)

Additional Contact Phone:

Nominated Voting Delegate

Voting Delegate Name (required)

Voting Delegate Email Contact Email (If different from above)

Voting Delegate Phone Number (If different from above)

Your Logo

Logo #2

T&C's:

We will email you material from time to time, subscribe you to our monthly email, provide you with resources to share with your organisation to encourage more people utilising membership. We will aim to feature all members yearly at a minimum.