Institutional membership application/renewal form

INSTITUTIONAL MEMBERSHIP APPLICATION/RENEWAL FORM
You are invited to renew or apply for Institutional Membership of Educate Plus for an annual fee of $990 (excl GST).

Institutional Membership provides you with 3 full memberships and an unlimited number of Associate Memberships.

Full benefits may be gained for the additional Members by payment of $100 (excl GST) per person. This fee will allow the full range of member benefits and can only be taken up as an add-on to Institutional Membership.
Items not included in Associate membership:

• 
  Access to Scholarships
  
• 
  Access to Educate Plus Special Awards (Trevor Wigney etc)
  
• 
  Use of post nominal M.Edplus & F.EdPlus – unless individual membership or add on membership is taken out – or they already hold a Fellowship.
  
• 
  Membership years criteria as part of the Fellow nomination unless individual membership/add-on membership is taken out.
  
• 
  Voting Rights
  
• 
  Ability to serve on a Chapter Committee
  

DETAILS

Institution Name		     
Institution Address: Street:		     
City:	     	Postcode:	     

Details of 3 full membership nominees ($990 excl GST)

An appointed representative should complete this form on behalf of their Institution.

1. Name:	Title	     	First Name	     	Surname	     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
2. Name:	Title	     	First Name	     	Surname	     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
3. Name:	Title	     	First Name	     	Surname	     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     

ADDITIONAL MEMBERS

Please add the names and details of all your additional members.

4. Name:	Title	     	First Name	     			Surname		     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
Category (Select one)	Additional Full Member ($100)					Associate Member		
5. Name:	Title	     	First Name	     			Surname		     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
Category (Select one)	Additional Full Member ($100)					Associate Member		
6. Name:	Title	     	First Name	     			Surname		     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
Category (Select one)	Additional Full Member ($100)					Associate Member		
7. Name:	Title	     	First Name	     			Surname		     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
Category (Select one)	Additional Full Member ($100)					Associate Member		
8. Name:	Title	     	First Name	     			Surname		     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
Category (Select one)	Additional Full Member ($100)					Associate Member		
9. Name:	Title	     	First Name	     			Surname		     
Position/Work title:	     
Email Address	     
Direct Line:	     
Mobile:	     
Category (Select one)	Additional Full Member ($100)					Associate Member		

(add more if required)
Please save and send this form to membership@educateplus.edu.au
Based on the information provided above, your institution membership fee will be calculated and an invoice will be drawn up and emailed to you.

To whom should this invoice be sent?

Name:	     
Position:	     	Email address:	     

Notes:

1. 
   Members are not required to take out Institutional membership. (although this is encouraged) Individual membership options remain.
   
2. 
   Where members’ renewal dates differ, a pro rata calculation may be made to align them all.
   (Contact Operations Manager: membership@educateplus.edu.au )
   
3. 
   Associate Members can attend all Educate Plus events at ‘Member’ rates.
   
4. 
   Fellowship discount does not apply to Institutional member rates.
   

Benefit Summary	Full	Associate
Use of the M.Edplus post-nominal	Yes	No
Scholarships	Yes	No
Access to Training and Professional Development	Yes	Yes
Member rates for conferences	Yes	Yes
Access to Excellence Award Program	Yes	No
Potential for Fellowship	Yes	No
Voting Rights	Yes	No
Committee Representation	Yes	No

www.educateplus.edu.au | membership@educateplus.edu.au | 0413932600 + + + +

Directory: wp-content -> uploads -> 2015
2015 -> Police Militarization
2015 -> 2015 ihbb championships: hs history Bowl Round 4 – Prelims First Quarter
2015 -> Wrtp/big step · 3841 W. Wisconsin Ave., Milwaukee, wi 53208
2015 -> Rao bulletin 1 December 2015 html edition this bulletin contains the following articles
2015 -> Darton College
2015 -> Training Workshop on Planning and Implementation of Multi-Sectoral Development Programme (MsDP) in Bihar Date : 6th
2015 -> Rao bulletin 15 June 2015 html edition this bulletin contains the following articles
2015 -> Rao bulletin 1 September 2015 html edition this bulletin contains the following articles
2015 -> Rao bulletin 1 August 2015 html edition this bulletin contains the following articles
2015 -> Science, and transportation united states senate