Membership Application and Payment

Application Form

* Required

Title

First Name *

Surname *

Email Address *

Organisation / Company

Address *

City *

State *

Postcode (or Zipcode) *

Country *

Phone Number *

Fax Number

Payment Method *
Paypal
Credit Card
Direct Deposit

Select Membership Type *
Member - $50 joining fee
Corporate Member - $150 joining fee
Student Member - free

Student Number (required for student membership only.)*

Choose a password (To be activated on membership approval) *

Confirm your password *

Enter Word Verification in box below *

The Australian Ceramic Society
Westpac Bank
BSB 032-017
Account No. 000 100 696

Our Corporate Members: