Become A Member Members Company Name * Application Date * ABN * Postal Address City * State * StateACTNSWNTQLDSAVICTASWA Postcode * Contact Details Primary Contact Person * Primary Contract Position * Primary Contract No * Primary Contract Mobile * Primary Contract Email * Secondary Contact Person * Secondary Contact Position * Secondary Contract No * Secondary Contact Mobile * Secondary Contact Email * Membership Schedule Category * Corporate Members Platinum Gold Silver Bronze Non-Voting Annual Contribution (excl. GST) $21,000 $15,750 $9,500 $5,250 $1,750 Payment Details * EFT: Please contact MITEZ for Bank Account Information Invoice; please forward any purchase orders to accounts@mitez.com.au All new organisations must be nominated and seconded to become a MITEZ member. Your MITEZ membership application is pending Board approval. Declaration * I have read, understood and agree to the Conditions of Membership as outlined in the MITEZ Constitution. If you are human, leave this field blank. Submit