Membership aPPLICATION / rENEWAL Become a Member of West Ryde Chamber of Commerce PLEASE FILL OUT THE MEMBERSHIP REGISTRATION FORM BELOWMembership Type :(Required)(GST Free) Not For Profit $108 Standard $288 Premium $495 (Please refer to the MEMBERSHIP BENEFITS attached on the last page.)PERSONAL INFORMATIONBusiness Name: ABN: Industry : Representative Name: Position: Business Address: Street : StateACTNSWNTQldSAVicWASuburb : Postcode: Mobile Number:(Required)Email Address:(Required) Website: Company Linkedin URL: 1 Liner Pitch for your Business: MEMBERSHIP BENEFITS(Please refer to the MEMBERSHIP BENEFITS attached on the last page.)PAYMENT OPTIONHiddenPAYMENT OPTION EFTPOS DIRECT DEPOSIT Account Name: West Ryde Chamber of Commerce Inc. BSB: 032 - 280 Account No.: 249 025Please INCLUDE your BUSINESS NAME with the Payment. Please contact the Membership Director on membership@westrydechamber.com.au for any enquiries.TERMS & CONDITIONS Information collected by the West Ryde Chamber of Commerce (WRCC) from applicants and members is used for the purpose of maintaining membership records of the WRCC and providing members with the benefits of membership. Your contact details may be included in the WRCC members’ directory, newsletter and events mailing lists. By completing the membership application, you grant the WRCC permission to use the information in the membership profile, including artwork, logos and photos for marketing purposes for the WRCC displayed on the website or social media channels and promotional marketing material. By completing the membership application, you agree to authorise and release any photos taken of you or your business at WRCC events can be used for marketing purposes for the WRCC displayed on the website or social media channels and promotional marketing material. Full Name(Required) HiddenSignature of Applicant/Authorised Person Date DD slash MM slash YYYY CAPTCHACredit Card PhoneThis field is for validation purposes and should be left unchanged. Δ