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Applicant Details
Full Name of Applicant/Organisation
All members are classified organisations, unless joining as a community member, only then do you fill in your own name (see the categories below). All other applicants must fill in the name of the organisation.
Unit and Street Number
Street Address
City
Postcode
desires to become a member of Maribyrnong & Moonee Valley LLEN Incorporated
Class of Member
Please tick the appropriate box for the class of Member to which you belong:
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Community Member
Organisational Member
Privacy Statement
Please note that as required your membership details may be provided to other members or member organisations. If you do not wish your details to be distributed, please notify the M & MV LLEN in writing (marniecraig@mmvllen.org.au).
Membership Category for Organisational Members
If an Organisational Member, please cross the appropriate Membership Category box (An Organisational Member may belong only to one Membership Category):
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Schools
TAFE Institutes or Universities with TAFE sectors
Adult Community Education organisations
Other education and training organisations including private registered training organisations, universities and group training companies
Trade Unions
Employers/Peak employer organisations/Regional employer organisations and employment agencies
Local governments
Other community agency and organisations, Commonwealth and State government departments, Adult, Community and Further Education Regional Councils, Regional Youth Councils, Area Consultative Committees, etc
Koorie organisations, Peak Koorie agencies or Regional Koorie organisations
Not Applicable (if you are applying as a Community Member)
Acceptance
If admitted as a member, I/We agree to be bound by the Rules of the Association for the time being in force.
Name of Representative
Position
Position Held (if an Organisation)
Email
Phone
Mobile
Fax
Date
(An application on behalf of an organisation must be signed by a person who has the requisite authority, such as a director, chief executive officer, secretary or other authorised officer of that organisation.)
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