Group Membership (30 Members) | herdsa.org.au

Group Membership (30 Members)

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Group Membership (inc. GST):

30 Members: $4260.00

This membership includes:

30 Members: 3 free pre-conference workshops, 3 free Associate Fellowship applications ($330)

First Name *

Last Name *

Contact Details for Main Contact

Email *

Phone Number

Street Address

City

Postal Code

State/Province

Organisation Details

Your organisation

Organization Name *

Department

As the main Point of Contact, are you also one of the members? *

Yes

No

If yes, you don't have to repeat your details further down in the form when adding details of subscribers as part of this team subscription.

Relationship to Contact 1 Relationship Type(s)

Employer of

Member employee is

Point of Contact is

Member 1

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 2

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 3

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 4

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 5

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 6

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 7

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 8

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 9

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 10

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 11

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 12

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 13

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 14

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 15

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 16

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 17

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 18

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 19

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 20

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 21

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 22

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 23

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 24

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 25

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 26

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 27

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 28

Existing Contact

First Name *

Last Name *

Email *

Department

Add another?

Yes

Member 29

Existing Contact

First Name *

Last Name *

Email *

Department

You indicated that you as PoC are one of the 30 members, therefore you do not need to add any more details. If you are not one of the 30 members then please scroll back to near the top of the form and change the answer you gave to "As the main Point of Contact, are you also one of the members? "

Add another?

Yes

Member 30

Existing Contact

First Name *

Last Name *

Email *

Department

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