Registration Membership Level* Basic Membership Supporter (A supporter is someone who lives outside the Great Lakes area) Organisation Are you a New Member or Renewing your Membership* I am a new Member I am renewing my membership Total $ 0.00 Personal DetailsEmail Address* Enter Email Confirm Email Your Title* Mr Mrs Miss Ms Please provide your Full Name:* First Last Primary Address* Street Address City State Postcode Postal Address* Same as above Street Address City State Postcode Phone/Mobile Number*Work Number (if applicable)Would you like to volunteer?* Yes No What skills or interests would you like to provide to the station?*Membership Consent* I do hereby make application to become a Member of Great Lakes Area FM Community Radio Association Incorporated and request you to enter my name on the Register of Members. If accepted, I certify I understand and abide by the Constitution and all other rules of the Association. I, the above named nominee, do fully understand that I cannot be elected as a Member of the Association until the Committee Management meeting following the expiration of fourteen days (14) from the date hereon. In support of my application, I confirm that I am a resident of the area that was previously administered by Great Lakes Council. Note: it is a requirement of the Australian Communication and Media Authority (ACMA) that only those who reside in ACMA Radio Area Forster RA1 can be members of the Association , Forster RA1 as defined by ACMA and the Great lakes Council Boundary are the same.Payment DetailsCredit CardCard Details Cardholder Name Help us to combat spam!PhoneThis field is for validation purposes and should be left unchanged.