Please complete the form below and post it to:
For 2013-2014 | |
Company name: | |
Representative's name: | |
Representative's position: | |
Street Address: | |
Suburb: | |
State: | |
Postcode: | |
Postal Address: | Same as Street address OR |
Suburb: | |
State: | |
Postcode: | |
Business phone: | |
Fax: | |
Mobile: | |
Email address: | |
Website | http:// |
SERVICES OFFERED: | Vacuum excavation |
Utility location or survey | |
Cable faults | |
Camera | |
G.P.R. | |
Leak location | |
Industry supplier | |
Civil Works/Infrastructure | |
Training Organisation | |
TELSTRA ACCREDITED? | Yes Number: No |
MEMBERSHIP TYPE: | Fees are in Australian Dollars annually |
Tier I - Locaters: $375 | |
Tier II - Training Authorities: $500 | |
Tier III - Manufacturers: $500 | |
Tier IV - Utilities, etc | |
NOTE: New members joining fee: Add $50.00 (one-off) | |
Why did you join NULCA? | |
PAYMENT DETAILS I will transfer the money via EFT/Internet bank transfer (details below) EFT (Internet banking transfer) details: Bank: Westpac |
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AUTHORITY TO DISPLAY DETAILS ON NULCA WEBSITE | |
I authorise my company's details to be displayed on the NULCA website member list |