Non-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 Non-Corporate Membership Application PDF (130KB)

* denotes a required field

On behalf of, (The Company), I hereby apply for Industrial Associate Membership of the Institute of Plumbing Australia, Incorporated and agree that on acceptance of the membership determined by the Council, the Company will conform to the Constitution of The Institute and as far as shall be within our power, promote and uphold its objects.

We 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.


COMPANY DETAILS

Company Name *
ABN *
   
   
Company Address: Company Postal Address:
 
Street Address *
Street Address
Suburb *
Suburb
Postcode *
State *
Postcode
State
   
Business Contacts:
   
Telephone *
Signed By *
Facsimile *
Signature (type your name in capital letters)*
Mobile *
Date*
/ /
Email Address *
Website
 
   


COMPANY NOMINEE:

Industrial Associate Members must appoint a Representative to represent the Company Membership. Please complete the Company Nominee section below when applying for Industrial Associate Membership, Institute information will be forwarded to the Nominee from time to time. However should the Company require a second copy of the information forwarded directly to the Company Office please indicate at contact name below.

Surname *
First Name *
 
Company Nominee Contacts: Nominees acceptance:
   
Telephone *
Signature (type your name in capital letters)*
Facsimile
Date*
/ /
Mobile
 
Email Address *
 
Company Contact For:

AccountsInformation
Name *
Email *




COMPANY ACTIVITIES:

Please list your company's activities:




DECLARATION BY APPLICANT:

By signing this application, the Company Nominee agrees that the Company will abide by the Constitution of the Institute and that the Company shall meet its responsibilities in regards to annual subscriptions, as set from time to time by the Institute Council. Where possible, the Company will support the aims and objectives of the Institute to inform the Membership, through the Institute, of changes in Products and Technical knowledge that will enhance the Plumbing Profession.

Upon receipt of this application, the Institute of Plumbing Australia will issue The Company an invoice for payment of $286.00 (including $26.00 GST), being for annual subscription (January-December) for Industrial Associate Membership.

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




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: