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Application form

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CAREERdrive

AfMA Membership Application Form / TAX INVOICE
ABN: 71 365 485 449

All Australian subscription fees below include 10% GST

Corporate Member			Membership Fees
Fleet Size	Number of Contacts	Category	Australia	New Zealand
Up to 250	1	CM1	AUD $335	AUD $305
251 to 500	2	CM2	AUD $630	AUD $573
501 and above	3	CM3	AUD $1,050	AUD $955
Affiliate Corporate Member Only available to an individual employed by an organisation who is a current financial CM1, CM2 or CM3 Member.		CM4	AUD $335	AUD $305

Supplier Member		Membership Fees
	Category	Australia	New Zealand/ International
Vehicle Supplier Member A manufacturer, importer, distributor or supplier of vehicles	SM1	AUD 2,025	AUD $1,840
Supplier Member Parts and Services A manufacturer, importer, distributor or supplier of parts and services (including fleet management)	SM2	AUD $1,080	AUD $982
Affiliate Supplier Member Only available to an individual employed by an organisation who is a current financial SM1 or SM2 Member.	SM3	AUD $345	AUD $314

* Required

Title

First Name *

Last Name *

Email Address *

Company *

Work Address *

City *

State *

Zipcode/Postcode *

Country *

Work Phone Number *

Cell Phone Number *

Work Fax Number *

Cars *

LCVs *

Trucks *

Misc *

Corporate/Supplier Member: *
CM1
CM2
CM3
CM4
SM1
SM2
SM3

Position

Name on Card *

Card Number *

Card Expiry *

Card Type *

CCV Number *

Amount *

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