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Membership Application
Membership
Application
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Indicates required field
Registered Business Name
*
Name of the registered business in Qld
Business Category
*
Please specify the business catagory which you would like to be listed. eg Motor Mechanic, Builder etc
Business Email
*
Main email for the business
Main Business Phone
*
Main phone number for the business
Business Address
*
This can be a physical address or post office box
Postal Address
*
Leave blank if same as business address
Contact Person
*
First
Last
Name of person authorised to make this application on behalf of the business.
Contact Persons Email
*
Complete if different from the Main Business Email Address
Contact Persons Phone
*
Leave blank if this is the same as the Main Business Phone
Other Information/Comments
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Enter any other information or comments you would like to provide here.
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