EPLA Membership subscription form

Hello, welcome to the EPLA membership subscription form.

Membership Application/Renewal (Required)

Existing member
New member

Membership type (Required)

Please select membership type. If you or your organisation is based in an outer metropolitan, regional country or interstate area. You are entitled to a 25% discount.

Individual $220.00
Student (F/T Course) $66.00 (please provide name of course below)
Corporate rate $770.00 (please provide names to be covered by membership below)
Councils & Government Departments $495.00

Your E-Mail Address (Required)

Surname (Required)

Please enter your surname

Other Names (Required)

Please enter your first and other names.

Occupation

Please enter your occupation

Organisation

Please enter your organisation name

Position

Please enter your position

Postal Address (Required)

Please enter your postal address

DX Address

Telephone

Facsimile number

Mobile

Student F/T Course:

If you are purchasing a student membership please enter your course.

Names to be covered by membership

If you are purchasing membership for an organisation, please provide the names and email addresses to be covered by the membership.

Please indicate your payment method (Required)

Cheque

Direct Debit

Credit Card

Payment options:

Cheque made payable to Environment and Planning Law Association (post to Michele Kearns, EPLA, Martin Place Chambers, Level 6, 65 Martin Place, Sydney NSW 2000 or DX 130 Sydney)

Direct Deposit: Bank - St George Bank; Account Name - Environment & Planning Law Association Business Account; BSB - 112-879; Account No - 422 672 608 (please provide proof of direct debit payment)
Credit Card (complete the attached form and fax to 8227 9699 or email to admin@epla.org.au)

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