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APPLICATION FOR MEMBERSHIP

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          Please print this page, sign at the bottom.         Scan the completed form then email it to: redl2000@aol.com 
          Preferred payment method is by direct deposit to :    BSB: 484799 Account number: 04764 5503         Use your name as reference

OR

You can post a cheque to: The Secretary,  Aquaculture Association of Queensland. 212 North Isis Rd. Childers 4660

          YOU CANNOT JOIN AS AN ASSOCIATE MEMBER IF YOU HOLD A DEVELOPMENT APPROVAL FOR AQUACULTURE. YOU MUST JOIN AS A FULL MEMBER.
Company Name:  

 
Name/s of owners  

 

Postal Address:

  

 

Street or road  

  
City or town:

Post code

  
Email Address .
Web site address .

Phone numbers: 

 AH Office Mobile
Do you hold an aquaculture license or a Development Approval for aquaculture Yes

No

 Please enter number  

 What is the type of business you are in, (eg grow-out, hatchery, ornamental. )

 
 List the species or product your business sells or produces. For licensed members this  information will be used on this web site to direct potential customers to  your business. This is free for licensed members, for associate members please contact the  president to discuss a web listing.

 

 

 

 

 

 

 

 
    I understand and shall comply with the terms and conditions of the AAQ and it's codes of conduct and practice.

    Applicant's signature

 

  Enclosed, (Circle one) 

$285.00 licensed membership:           $65.00 for Associate membership: 

$165.00 interstate licensed membership:           Overseas membership AUD$115