Application for Membership of IIMPACT Educating the Girl Child, Inc.

To:

IIMPACT Educating the Girl Child Incorporated
(incorporated under the Associations Incorporation Act 2009)
NSW Incorporation No: INC1300151
Australian Business Number: 744 681 72781

[contact-form][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Address Line 1′ type=’text’ required=’1’/][contact-field label=’Address Line 2′ type=’text’/][contact-field label=’City’ type=’text’ required=’1’/][contact-field label=’State’ type=’text’/][contact-field label=’Post Code’ type=’text’/][contact-field label=’I have read the Constitution‘ type=’checkbox’/][/contact-form]

By clicking the Pay Now button below, I hereby apply to become a member of the above named incorporated association.  In the event of my admission as a member, I agree to be bound by the Constitution of the association for the time being in force.




You will be linked to a PayPal payment page for payment of the $100 Membership Fee (you do not need to be registered with PayPal, credit cards are accepted).

For any further information about membership, please email admin@iimpact.org.au.