COUPLE - MEMEBERSHIP APPLICATION

You are now Applying (New) / Re-applying (Renewal) to the Ballarat Italian Association [BIA] for a Membership as a COUPLE.

COUPLE APPLICATION INSTRUCTIONS:
To finish your application, you must please complete all 4 steps below:

1. Complete ALL questions in the form below.
2. Choose your payment method under the form below:
   • ONLINE ie. Credit Card
   • OFFLINE ie. Internet Banking, Bank Branch Deposit, Cheque or Money Order (Options detailed below).
3. Click the [APPLY] button at the bottom of this form to proceed to the Payment Confirmation Screen.
4. On the Payment Confirmation Screen click the [SUBMIT] button at the bottom to finish your application.

MEMBERSHIP TERMS: 
[1] Your Membership with The BIA begins once:

[a] this Application Form is fully completed,
[b] you agree to be bound by the rules of the BIA and [c] successful fee payment is received.

[2] Your application is presented for review to the Committee of Management as per the rules of the Association.
[3] On completion of the review, you will only be formally notified if your application is rejected.

WORDS WITH SPECIAL MEANINGS/DEFINITIONS:
[YOU] – The person applying for membership to the BIA.
[SPOUSE/PARTNER] – The additional adult to be included in the membership.
[NOMINATING MEMBER] – A current member of the BIA who is who is personally known by YOU, who is nominating YOU for membership of the Association.
[SECONDING MEMBER] – A current member of the BIA who is personally known by YOU, who seconds YOUR nomination for membership of the Association.

OTHER/OFFLINE PAYMENT OPTIONS DETAILED:
[1] INTERNET / APP BANKING:
Pay your applicable fee using your Internet Banking Provider. Use the “Pay Anyone” option with the BIA set as your
Payee. Contact your Provider for assistance if required:

[BANK] Bendigo Bank.
[BSB] 633000.
[ACCOUNT NO] 163099450.
[REFERENCE] Your Full Name.

[2] BENDIGO BANK BRANCH DEPOSIT:
Visit any Bendigo Bank Branch to pay your applicable fee via Cash / EFTPOS into our bank account listed here:

[BANK] Bendigo Bank.
[ACCOUNT NAME} The Ballarat Italian Association.
[BSB] 633000.
[ACCOUNT NOJ 163099450.
[REFERENCE] Your Full Name.

[3] CHEQUE / MONEY ORDER PAYMENT:
Pay your applicable fee via cheque / money order.

[MADE PAYABLE TO]
The Ballarat Italian Association.

[POST TO]
Attention: Treasurer RE: Membership.
The Ballarat Italian Association.
PO BOX 167, BALLARAT VIC 3353.

Price:

$40

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

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State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Mobile:* Mobile is Required

Spouse/Partner First Name [C]:* Spouse/Partner First Name [C] is Required

Spouse/Partner Last Name [C]:* Spouse/Partner Last Name [C] is Required

Nominating Member [Enter N/A if no Nominating Member]:* Nominating Member [Enter N/A if no Nominating Member] is Required

Seconding Member [Enter N/A if no Seconding Member]:* Seconding Member [Enter N/A if no Seconding Member] is Required

Without Member Nomination [To assist the application process could we please ask how you heard about the BIA and why you would like to be a member]: Without Member Nomination [To assist the application process could we please ask how you heard about the BIA and why you would like to be a member] is not valid

In the event of my admission as a member, I agree to be bound by the rules of the Association.*

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Have a coupon?

Coupon Code: Invalid Coupon Coupon applied successfully

Online Payment Options

Pay with your credit card via Stripe

Other/Offline Payment Options

Offline payment options via direct credit using your Internet / App Banking, Deposit at Bendigo Bank Branch or Cheque / Money Order.

 

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