Glen Innes Highlands Visitor Association

Partnership Application

1 July 2019 - 30 June 2020

Partnership options*

Premium Partner..........$1,000 gst inc.
Standard Partner..........$300 gst inc.
Affiliate Partner..............$75 gst inc. (Not for profit & private individuals)

Name*

First Name Surname

Address*

Street Address Suburb State Post Code

Telephone

Mobile

Facsimile

Web address

Please include http:// or https:// in the address

Email

Organisation

Nature of business

Please indicate your business category

Consent

Please indicate your acceptance for membership with the NSW Business Chamber. There is no additional cost to you.

Signature*

Payment method

Options*

Cheque
Direct Deposit

Please forward payment to:
Glen Innes Highlands Visitor Association
PO Box 110
GLEN INNES NSW 2370

OR
Direct Deposit
BSB 062-542
ACC 28006492
Reference Business Name

MEMBERSHIP IS TAX DEDUCTABLE
ABN: 60 647 058 432

A Tax Invoice will be forwarded with your receipt.
Payment must be received prior to 30 June 2019 to maintain member benefits. Following this date if membership is not renewed, all website reference and individual business promotion material displayed on gihva.com.au or at the Visitor Information Centre will be removed.

Send a copy of the completed form to my email address

YES

Complete & submit the application online or download, print and return to the address on the form

Glen Innes Highlands Visitor Association

Partnership Application

Payment method