AUSTRALIAN COFFEE TRADERS ASSOCIATION INC
P O BOX 371
COOGEE NSW 2034
AUSTRALIA
For all enquiries please email
catherine@acta.org.au
MEMBERSHIP APPLICATION FORM
(To print, highlight form, select "copy" from the Edit menu, open
Microsoft Word, paste to a new document, then print).
Note:
please do not make payment before the application is approved
Australian Coffee Traders Association inc.
ABN: 85 439 269 497
PO BOX 371 COOGEE NSW 2034
APPLICATION FOR MEMBERSHIP
Company Name
Address
State Post
code
Contact Name
Telephone
Fax
Mobile
Email
(Please select one membership
category)
Full Member,12 months; $500.00
Grower/Exporter/Producer
Importers/Green Brokers
Roasters /
Wholesalers
Associate Member, 12 Months:
$375.00
Coffee Machinery Manufacturer
Food
service/Distributor/Other
Note: please do not make payment before the application is approved
Payment can be made by,
Cheque: (payable to) Australian
Coffee Traders Association
Direct Deposit:
National Australia
Bank, 082 128 01777 6542
Please indicate the method of payment,
Name & Signature:
................................................
Please
complete, sign and return this form to the address above for application
approval
A tax invoice will be forwarded when application is approved and
transaction completed, along with current Membership Certificate.