Membership Application Step 1 of 520%Business DetailsCompany Name (if applicable)Business or Trading Name*Owners Name* First Last Managers Name*ABN*Phone Number:*Fax Number:Business Email Address* Website Address Preferred Contact MethodEmailPhoneNumber of Full Time EmployeesType of BusinessCompanyPartnershipSole TraderOtherIf other - Please describeCompany Profile (used for key word searches)Industry Type*ServicesRetail/Tourism & HospitalityGovernment/Not for ProfitConstruction/ManufacturingEngineering & ResourcesBusiness Address DetailsStreet Address - Line 1Street Address - Line 2*City or Town*StateWANSWNTACTQLDTASVICSAPost Code*Postal Address* Main ContactContact Name* First Last Phone NumberMobile Phone Number*Email* Position or TitleAdd any additional contacts from your organisation who would like to receive the MWCCI newsletter1 name & email address per line Membership TypeAdditional Business - $250.00 Should you wish to add another business owned by you to your membership Sole Operator - $250.00 Sole operator or home based business - no employees Specialist Group Membership - $345.00 Business Groups, Rotary, Rostrum, other local Chambers, Local Charity Groups, NFP's, Political Leaders Membership Small Business - $470.00 1 - 5 FTE- Employees Membership Medium Business - $580.00 6 - 15 FTE- Employees Membership Large Business - $700.00 16+ FTE- Employees Government Agencies - $705.00 Any Government Agency Platinum Member - $7500.00 Contact MWCCI for details on this membership type Diamond Member - $11500.00 Contact MWCCI for details on this membership typeSelect your membership package*Additional Business (no employees) - $250Sole Operator - $250.00Specialist Group Membership - $345.00Membership Small Business - $470.00Membership Medium Business - $580.00Membership Large Business - $700.00Government Agencies - $705.00Platinum Member - $7,500.00Diamond Member - $11,500.00 Membership approvalYour application for membership will be considered by the Executive Committee of the Mid West Chamber of Commerce & Industry (MWCCI). If the Executive Committee accepts your application you will become a member of the MWCCI. Upon acceptance you will remain a member of the MWCCI unless and until the Executive Committee receives a written notice of intent to resign your membership. You agree to be bound by the Constitution of the MWCCI, and the to comply with any rules and regulations as may be provided by the Executive Committee. A copy of the Constitution is available for you under the "Documents" section of this website. A copy of rules & regulations (if any) will be provided upon request. Upon acceptance, your membership details (including your business name, contact person name, phone number and business street address) will be added to the MWCCI members directory. The MWCCI members Directory is available on this website. This information will be available to the public.Would you like your membership details to be added to the MWCCI members directory.MWCCI will not include any other membership information (and specifically, will not include your email address) in it's members directory. The MWCCI will not provide any other membership information (and specifically, will not include any email addresses) to any other person or entity other than as required by law. Yes NoWould you like your membership details to be added to the Chamber of Commerce & Industry.MWCCI will not include any other membership information (and specifically, will not include your email address) in it's members directory. The MWCCI will not provide any other membership information (and specifically, will not include any email addresses) to any other person or entity other than as required by law. Yes NoYour Full NameYour PosistionNameThis field is for validation purposes and should be left unchanged.