business member form

Membership

All amounts include GST. Membership is valid for 12 months (and covers January to December each year).

First Name *

Last Name *

Email Address *

Cell Phone Number *

Organisation/Business Name

ABN Number

Position

Adress *

Postcode

Website

Postal Address (if different from above)

Postcode

Contact

Telephone

How did you hear about CIA membership?
Friend
Website
Magazine
Newspaper
Radio
Other

Payment Type

Amount Amount *
(inc GST)

PO Box 667, Applecross WA 6953

Phone: 0409 688 166

ABN: 94 567 095 903

The names of 2026 Gold Plate Finalists will be announced on Monday 20th July 2026. The list will be posted the Tuesday 21st July.