Good Life Cooperative

Membership Form


I/ We wish to apply for membership of the Good Life Coop in the following category:
  (please tick one box only)

Individuals and families in receipt of care and support packages

Support organizations committed to self-direction and mutual supports

Support workers committed to working in a personalised way

Individuals and families not currently in receipt of a package
 

Name
Organisation
Tel
Email
 Address
Address 
State
Postcode
Country

Please describe your current situation and your interest in membership:


Membership Category 

Joining Fee      

Individuals and families (including current and potential holders of packages)   $20     
Support organizations committed to self-direction and mutual supports    $500    
Support workers committed to working in a personalised
way 
$20  


[For package holders only] I am currently involved in a Circle of Support and/or Network of Peers

Please describe your experience in these:                                                                     

 

 
I/ We wish to express an interest in joining the inaugural board of directors of the
      cooperative

 Please describe your interest in joining the board and your relevant skills and experience:

 
 

Payment Options
            
 
I will send my cheque/money order to  Social Enterprise Partnerships
PO Box 159
Yarraville VIC 3013
(Cheque payable to Social Enterprise Partnerships)
OR  
I will pay by EFT transaction:

 

 

Bank: Commonwealth Bank of Australia
Account name: Social Enterprise Partnerships Ltd
BSB: 062 218
Account number: 1007 2945
Please send a tax invoice.

  I have read, and accept the terms and conditions described below.

 
 


Terms and Conditions  
 
1. Monies received will be held in trust for the Good Life Cooperative by Social Enterprise Partnerships and reserved solely for use by the Good Life Cooperative.
2. Membership applications must be accompanied by payment in full for the appropriate Joining Fee.
3. The formation meeting for the Good Life Cooperative will be held in March 2018.

Social Enterprise Partnerships Ltd
ABN 47108742098
PO Box 159
Yarraville Vic 3013