Application Form - Orgs | Australian Participatory CD Institute

Membership Application: Organisations and Government Departments

Organisation/Institution

ABN/ACN

Postal Address

Address line 2 (optional)

Suburb

State/Territory

Postcode

Tell us a little about your interest in participatory community development?

Select Fee Category

Government $300

Large NGO/Company (>$2m p.a.) - $300

NGO/Company (>$500K p.a) - $150

NGO/Company (<$500K p.a) - $75

Payment Details:

Account Name: APCDI (Australian Participatory Community Development Institute)

Bank Name: Bank Australia

BSB: 313 140

Account Number: 125 769 38

Details of nominated representative

First name

Last name

Role/Title

Phone

Secondary /back up organisational email

Declaration

I have authority to sign up on behalf of the applicant organisation

We commit to the vision and objectives of the Australian Participatory Community Development Institute Ltd.

On approval of your membership, you will receive an email invitation from Tallystone, APCDI’s data management system. Please accept the invitation to access Tallystone and view your membership detail