ASSOCIATE MEMBERSHIP APPLICATION 2011 Reply Paid PO BOX 418 FORTITUDE VALLEY QLD 4006 Ph: (07) 3839 7020 Fax: (07) 3839 7021
Freecall: 1800 177 938 members@ieu.asn.au www.qieu.asn.au Membership No
ABN 45 620 218 712
IEUA-QNT REPLY PAID 418 FORTITUDE VALLEY QLD 4006
Ph: (07) 3839 7020 General Enquires: Membership Enquires:
Fax: (07) 3839 7021 enquiries@qieu.asn.au members@qieu.asn.au
To The Secretary, IEUA – Queensland and Northern Territory Branch I, Rev, Dr, Mr, Mrs, Miss, Ms
SURNAME
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DATE OF BIRTH
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HOME ADDRESS
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HOME PHONE NUMBER
EMAIL ADDRESS
ENROLLED AT
GIVEN NAME/S
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MOBILE PHONE NUMBER
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wish to apply for Associate Membership of the Independent Education Union of Australia – Queensland and Northern Territory Branch. Associate Membership entitles you to the full benefits of IEUA-QNT membership. Under Union Rules, Associate Members are not entitled to vote on any Union matter.
AREA OF STUDY Early Childhood
Secondary
Primary
Special Education
Other_________________________
COMPLETING STUDIES Mid 2011
End 2012
Mid 2014
End 2011
Mid 2013
End 2014
Mid 2012
End 2013
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SIGNATURE
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DATE
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BENEFITS OF ASSOCIATE MEMBERSHIP •
Access to publications including Associate Outlook, a monthly e-newsletter for associate members and Independent Voice, our signature journal
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Dedicated website area which provides information about finding employment, upcoming professional development opportunities and membership benefits
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Information about the wages and conditions offered by perspective employers
Associate membership is free while you are at university studying education