LGEMA Membership

Primary Government/Local Government Authority of Interest

Position

First Name *

Surname *

Postal Address *

Suburb *

My Email * This should be your private email address, not your LGA email

My Phone Number * Mobile or phone number (will not be used in Association Register):.

Occupation Occupation/skillset

Contact to be used for the Association’s Register * (which can be inspected by members):

Use above email Use Postal Address Use address below

* Address or Email address to be shown on register The address that will appear in the register

By submitting this form I acknowledge having received an electronic copy of the Association’s Rules and Hereby apply for Membership of Local Government Elected Members Association (“the Association”).

Dated :: Friday 19th Apr 2024