LGEMA Membership

Your Organisation

* Group / Association Name

* Group / Asociation type

* Primary Government/Local Government Authority of Interest

Facebook or Other Social Media address

Website

Street address (if applicable)

Suburb and Postcode (if applicable)

This form should be completed by someone in a position to speak for your organisation and authorise your membership request

* Position/Title [You can use either your personal or organisation email]

* First name

* Surname

* Contact Email
We'll never share your email with anyone else.

Mailing List Email (If you want notifications sent to your mailing list)
We'll never share your email with anyone else.

* Contact Phone Number
We'll never share your phone number with anyone else.

By submitting this form I acknowledge having received a copy of the Association’s Rules, dated;