Industry Affiliate Membership Application Step 1 of 2 50% Do you directly support, supply or provide services to retailers? Complete this membership application form and a member of the Australian Retailers Association will be in contact to discuss membership options available to industry affiliates. Company name Legal Entity ABN Postal / invoicing address(Required) Street Address Address Line 2 City Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia State Postcode Street address(Required) Same as billing address Street Address Address Line 2 City Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia State Postcode Office phoneServices Provided(Required)Describe your business services as they apply to the Industry Affiliate Membership criteria Your details You as the primary contact will be responsible for administering membership and updating details and invoices.Name(Required) First Last Job title(Required) Email(Required) Password(Required) Enter Password Confirm Password Passwords must have: a minimum length of 8 characters at least 1 lowercase letter at least 1 uppercase letter at least 1 number Mobile phone(Required)
Australian Retailers Association
