Application | Committee for Geelong

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Membership Application

Membership level*

Corporate Member - Annual Subscription $4,200 + GST

Corporate Plus Member- Annual subscription $24,900 + GST

Community Member- Annual 'Expression of Interest' Application

Please select the membership level you are applying for.

Organisation name*

ABN*

Location Address*

Postal Address

Organisation Logo

Website

Social Media Link

About your organisation*

Organisation brief (i.e. about your organisation) and its connection to the Geelong region and community

Primary Contact

First name*

Last name*

Email*

Phone*

Position*

Please add a secondary contact

Accounts Contact

Name

Accounts Email*

Accounts Phone

Signed for and on behalf of the organisation

Name *

Title*

Signature*

Date*

The Committee for Geelong acknowledges the Wadawurrung People as the Traditional Owners of the lands, waters, seas and skies on which we operate.

We pay our respects to their Elders past and present.

We acknowledge Aboriginal and Torres Strait Islander people as Australia’s First Nations people.

We commit ourselves to working for reconciliation with First Nations People and supporting them in having a voice.

Artwork by Ammie Howell

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