Graduate Registration Graduate Membership Application Membership Application Tax Invoice (ABN 60 4751 9619) Please copy this Tax Invoice for your records. All costs include GST. If you are human, leave this field blank. Surname * First Name * School/Organisation * ABN (if applicable) Website (if applicable) Postal Address * Suburb * Postcode * Home Phone * Mobile Number * Email * Membership * Continuing Member New Member Essential Information: EYES primary form of communication is by email so please keep your details on the web up to date. Once your membership is accepted an email will inform you of your user name and password for accessing members only resources stored on the website Membership Free for the first year * Individual Membership- $35.00 Student Membership - $20.00 Five Year Membership - $150.00 Optional EYES Membership Badge - $5.00 PAYMENT * CHEQUE: Make payable to Early Years in Education Society DIRECT DEBIT: BANKWEST BSB #: 306 - 107 ACCOUNT #: 416106 - 0 Please Note: Direct Debit payments: Please forward your receipt by email to Jodie McQueen [jomcqueen@iinet.net.au] or post to PO box PO Box 172, KARRINYUP WA 6921 Privacy Terms and Conditions 1. The Early Years in Education Society respects your privacy and is committed to the Privacy Act. The information collected on this form is used for the purposes of administration and communication only. A list of EYES WA members is kept on our website as a service to both members and potential clients. To be removed from this list, please contact the EYES via email to jomcqueen@iinet.net.au. 2. The Early Years in Education Society respects your privacy and is committed to the Privacy Act. The information collected on this form may also be provided to EYES Business Partners for the purposes of marketing. In such cases professional contact details will be released (IE SCHOOL CONTACT DETAILS NOT PERSONAL CONTACT DETAILS). To be removed from this list, please contact EYES via email to jomcqueen@iinet.net.au. Privacy * I Agree to the Privacy Terms and Conditions Please indicate how you became a member/became aware of EYES * Conference Word of Mouth Web Search School Matters Other FURTHER ENQUIRIES (e) For further information regarding memberships you can contact us at: . (a) PO BOX 358 SUBIACO 6164 Untitled Submit
