Ausdance NSW - Membership Form

(Add AUD$33 for an international membership)

* Concession is only valid with proof of full time student card, government concession or pension card.
* Please provide a copy of your concession card on registration.
* All membership prices include GST
* Membership is on an annual basis; valid for one year from registration

Please process my payment by:

	Cheque / Money order
	Mastercard	Visa
Card Number
Cardholder Name
Card Expiry
Amount

Title
First Name
Last Name
Company
Street Address
Suburb
Post Code
Email
Phone

I would like Ausdance NSW to contact me via email from time to time with news, events and special offers to dance productions.

I would not like Ausdance NSW to contact me via email with news, events and offers.

Please select a category below that best reflects your dance activities. This will also assist our office in keeping you up to date with relevant information and opportunities.

Student:	Dance Studio	Tertiary Education	Secondary School	Primary School
Teacher:	Dance Studio	Tertiary Education	Secondary School	Primary School	Freelance
Dance Artist:	Pre Professional	Freelance	Fulltime(Company)	Independent	Project Funded
Other:	Choreographer	Associated Professional	Dance Enthusiast	Arts Organisation