Corporate Membership Application

Complete the form below to apply for membership to the Institute of Plumbing Australia, Incorporated.

 

This form can also be downloaded and completed as a PDF. Download Corporate Membership Application PDF (88KB)

* denotes a required field

I, hereby apply to be to membership of the Institute of Plumbing Australia, Incorporated and agree that on acceptance of the Grade of membership determined by the Council, I will conform to the Constitution of The Institute and as far as shall be within my power, promote and uphold its objects.

I understand that resignation can only be granted to financial members who return their membership Certificate together with a written request to be released from foregoing Obligations.

YOUR DETAILS

Your Personal Details:  
Surname *
 Born at *
Given Names *
 on the *
/ /
   
   
   
Your Private Address: Your Postal Address:
 
Street Address *
 Street Address
Suburb *
 Suburb
Postcode *
 State *
Postcode
 State
   
Business Contacts:
   
Telephone *
  
Facsimile *
Mobile *
  
Email Address *
Website
 
   

DECLARATION BY APPLICANT:

I declare that the statements by me and the information attached to this application are true and I am prepared to submit proof of same on request. Enclosed is my payment of $176.00 (incl. GST of $16.00) being for annual (January – December) subscription for corporate membership ($160.00 + GST). For Student applicants please contact the Secretary for current rates and provisions. For Companies applying for Industrial Associate membership please use separate form.

Signature (type your name in capital letters)*
 Date*
/ /


GRADE TRANSFER (for upgrade only):

Year of admittance to Institute
 Present grade of membership


EMPLOYMENT HISTORY:

Please attach details of your past 5 years employment, stating Employer, Business Activity, Your Position and Dates of Employment.


EDUCATION AND TRAINING:

Please list particulars of ALL formal education, and any MAJOR Training Courses you have completed. Attach a separate list if insufficient room. Please DO NOT use initials. (Photocopies of the degrees, diplomas, certificates must be attached). You can attach a document below.

Name of School,University, College of Training Institution Location Qualifications Obtained or Examinations Passed Dates
       
1. (Trade)      
1.1
1.2
1.3
       
2. (Post Trade)      
2.1
2.2
2.3
       
3. (Other)      
3.1
3.2
3.3


Attachments

Please attach any supporting Education and Training documents:


MEMBERSHIP IN OTHER INSTITUTES OR ASSOCIATIONS:

Please list any memberships you hold in other Institutes or Associations:



FURTHER RELEVANT EXPERIENCE OR QUALIFICATIONS:

Please list any other relevant experience or qualifications you hold. Include any special or unusual attainments, designs, research work, jobs handled in Industry or Authorships





Next steps

Once submitted, your application will be received by the Institute of Plumbing Australia, Incorporated and will be reviewed. After review, you will receive an invoice to the email address you supplied above. Upon receipt of payment, your membership will be valid. Click on the 'Submit Your Application' button to submit your application: