Membership Application Form

Organisation *
Company activity *	Please provide 250 words for your company product/service description
ACN *		ABN *
Company phone *		Company fax
Company e-mail		Web-site URL
Office address Address * Suburb * State    P'code		Postal address Address Suburb State    P'code
No. of employees	(select one) Less Than 10 11 - 100 101 - 500 Over 500
Annual turnover	(select one) Up to $500,000 $500,001 - $5,000,000 $5,000,001 - $20,000,000 Over $20,000,000
Exports	%
Export markets	Countries
Aust. owned?	Yes   No
QA
Member of?	(select one) AIDN-ACT AIDN-NSW AIDN-Vic AIDN-Tas AIDN-SA AIDN-WA AIDN-NT AIDN-Qld None of the above
AIDN contact person details
Given name		Surname
Job title
Direct phone		Direct fax
Mobile		Direct e-mail
Activity keywords *	Please provide 20 keywords for search engines, separated by a comma.
Industry categories (select categories applicable to your company) * Aerospace C31 Catering & food Communications Computer software/hardware Construction Electronic Systems Engineering/Fabrication Environmental Federal/State Government Finance Information Technology Land (Vehicles, etc.) Legal/intellectual property Logistics Marine Medical Miscellaneous Personnel Support Procurement Project management Publications Research & Development Sensor Systems Security Services Textile/clothing Training Weapons Other
Did a current member refer you to AIDN? *
	Yes No
* Denotes required field