Membership Application Form

Company

Legal Name

First Name:

Family Name:

Preferred Name:

Membership Categories
Individual MemberCorporate MemberBusiness MemberHonorary MemberTrainee/Apprentice Member

Job Title （Electrician, electrical inspector, electrical technician, electrical engineer, apprentice etc.）

Years of working experience in the building industry

Company Address /Home Address

Street:

Suburb:

City:

Postcode:

Email

Phone Number

Work:

Mobile:

References

Name: phone:

Name: phone:

Declaration:
I declare that my statement is a true account of the professional experience. If admitted to membership, I / We agree to comply with the association constitution and to accept the corresponding rights, privileges, duties, responsibilities and obligations.