Membership Registration Step 1 of 4 25% Section BreakHiddenNext Steps: Install the Stripe Add-OnTo accept payments on this form you will need to install the Stripe payment add-on. Important: Delete this tip before you publish the form.Choose your Membership.All memberships are inclusive of GST and are annual subscriptions. Associate Membership (Individual, student, pensioner, retiree) $37.00 Small Enterprise (Gross Income less than $250,000) $189.00 Medium Enterprise (Gross Income $250,000 – $1,000,000) $420.00 Large Enterprise (Gross Income over $1,000,000) $814.00 Corporate Enterprise (legal firm, local government, Apple) $1310.00 Total Name First Last Email Website PhoneMobile PhoneCompany &/or Property Name Billing Address Street Address Address Line 2 City State Post code Postal address if different. Involved in or interested as Agriculture Government House Owner Student, Research, Science. Business Law Other Details on otherDo you have Joint membersOther family members or partners living or working at the same address.NoYes Enter your joint members belowFamily members or partners living or working at the same address.NameMember Number 1 First Last Date of BirthMember Number 1 MM slash DD slash YYYY NameMember Number 2 First Last Date of BirthMember Number 2 MM slash DD slash YYYY NameMember Number 3 First Last Date of BirthMember Number 3 MM slash DD slash YYYY NameMember Number 4 First Last Date of BirthMember Number 4 MM slash DD slash YYYY How would you like to pay for your membership? Credit card Direct Deposit / Check Total membership fee Credit CardCard Details Cardholder Name For membership payments please make cheques payable to: Property Rights Australia Inc. DIRECT DEBIT: Property Rights Australia Inc., BSB: 484-799 Account: 037 223 021 Please leave your name or invoice number as a reference.
