Supporter Membership (Associate C)

The ACA Qld Membership Year runs from 1 April – 31 March. Please enter information on the form below to join ACA Queensland.

Company Details

Only Ordinary Members or their Nominated Representative have the right to vote at General Meetings

Company Name / Trading Name *

Contact Person *

Position in company *

No of services you own or manage

Postal Address *

Suburb *

State *

Postcode *

Phone *

Mobile *

Email *

Website Address *

Category *

By submitting this application, you confirm that all information provided is true and correct and will notify us in writing of any changes. You understand and agree to The Rules of the Association, a copy of which can be found on the ACA Qld website.

Payment Information

Payment Terms

$735.00 for each Year

Regular subscription price

Regular subscription discount amount

Regular subscription tax

Payment Fee

Regular gross amount

Payment Method

Offline Payment

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

How did you hear about us? *

Other *