Membership Type:*

All amounts include GST (goods & services tax).
+ Denotes full membership voting rights.

or Other:

Australian:

Select No if you do not wish to
receive unsolicited correspondence.

Please select the activity in Country Music from
which you derive part or all of your income.

Please indicate the percentage portion of income derived from Country Music.

POSTAL ADDRESS

PROFESSIONAL MEMBERS ONLY

Automatically renew?:

Select to pay by
credit/debit card

Select to pay by
cheque/money order

NB: card payments attract a 2.5% surcharge

Percentage Income:

Activity:

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Website:

Email:*

Landline:

Mobile:

Country (if not Aust.)

Postcode

Title

First Name

Last Name

Line 1

Line 2

Suburb or Town

State

Please tick to have your membership renewed each Financial Year
on your credit card without you having to worry about it.

Valid to date:

CMAA Membership
PO Box 298
TAMWORTH NSW 2340

Membership #:

/

/

Please specify how you will be paying

Memberships are based on the Financial Year, and will take the membership through to 30th June, 2012.

Renewals then become d border-style:none; border-width:1px; border-color:#888888; ue on 1st July, 2012.

Membership # and valid to date can be found on your membership card and certificate.

(If you do not know your membership number type 000 in the Membership # field. If you do not know your valid to date type in 30/06/11)