I wish to join Social Enterprise Partnerships. I am currently 

           please choose an unfunded initiative-taker (or third sector volunteer) an employee of a third sector organisation a staff member of a goverment or public sector agency a staff member of a business employing up to 10 people a staff member of a business employing more than 10 people a full-time student

          Here is my contact information

Name
Title
Organisation
Phone
Fax
Email

Address
City
State
Postcode
Country

          Here are my Social Enterprise interests and/or achievements

INDIVIDUAL MEMBERSHIP CATEGORIES	COST
Unpaid community leaders and initiative takers and third sector volunteers	$   99(includes GST)
Staff members of funded organisations in the third (or community) sector	$   187 (includes GST)
Staff of government and public sector agencies	$ 242 (includes GST)
Staff of businesses employing up to 10 people	$  187 (includes GST)
Staff of businesses employing more than 10 people	$  286 (includes GST)
Full-time students	$  33 (includes GST)

	I will send a cheque/money order to
		Social Enterprise Partnerships 2 Elm Street North Melbourne 3051
OR

I will make a payment using the secure online credit card payment facility (Visa/Bankcard/Mastercard accepted) CLICK on this link NOW to use our secure payment system. Then close the window and submit this form.

I understand that, as a member, my details will be listed in the Social Enterprise Partnerships Directory of Members, which is to be launched in January 2006. (Access to the directory is password-protected and available to members only. Please CLICK HERE to let us know if, for any reason, you do not wish to have your details included.)

I understand that a tax invoice/receipt will be forwarded to me on receipt of payment.