Membership Application

Membership Application for Business Mudgee

"*" indicates required fields

Step 1 of 5

20%

1. Application for Membership of Association: Business Mudgee (BM)

I/We (full name/s)*

Owner of (business name)*

Of (trading address)*

hereby apply for this business to become a member of the Business Mudgee. In the event of my admission as a member, I agree to be bound by the rules of the association for the time being in force.

Signature*

Date*

Day

Month

Year

2. Application to become a partner of the Business Mudgee’s Mudgee Money gift card program

As a member of the Business Mudgee you are also able to join our Mudgee Money gift card program. Mudgee Money (MM) was set up by Business Mudgee in November 2017 as a further way to support local businesses and encourage people to shop locally.

Opt in

I am interested in joining the Mudgee Money gift card program as a redemption store and would like the Business Mudgee to contact me to explain the program further and arrange a time to set up our eftpos machine(s). The additional information required for set up is below:

Physical address (if not the same as noted above):

Eftpos terminal ID/Merchant ID (1):

Eftpos terminal ID/Merchant ID (2):

Eftpos terminal ID/Merchant ID (3):

Eftpos receipt name:

3. Business NSW Membership Declaration

As a member of the Business Mudgee you are entitled to a FREE Local Chamber Membership package with Business NSW, which includes access to a range of additional business tools and resources. For full membership benefits see www.businessnsw.com/Members/why-join.

Opt in*

I, the above named and being a financial member of the Business Mudgee, hereby agree to become a member of Business NSW (within the Local Chamber membership class) and be bound by the Business NSW Constitution, the Business NSW Membership Terms and Conditions, and the Business NSW Privacy Privacy Policy.

*Please Note: If you are already a member of Business NSW in a membership class other than the Local Chamber membership class and would like to move to the Local Chamber membership class, then you must first resign your existing membership.

4. MEMBER DETAILS: (Please print clearly)

Trading Name:*

First

ABN (If applicable):

Contact Name/s:*

Phone (Landline):

Mobile:*

Email:*

Website

Social Media

Please list the names and email addresses of all other people in your business you would like to receive Business Mudgee communication:

If we were to introduce you to fellow Business Mudgee members and to welcome you in our social media, what would you like us to say about your business?*

I wish to receive Business Mudgee e-bulletins and notifications:

Yes

I wish to be listed on Business Mudgee’s online local business directory:

Yes

My business category in the directory should be:*

(Type of business e.g. butcher, accountant, etc.)

5. MEMBERSHIP FEES

Membership Fees

$125 | I am a self-employed sole-trader up to 1 staff OR I am the employee of a local business

$250 | My business has a registered business name and employs between 2 and 9 employees

$380 | My business has a registered business name and employs 10 or more employees

*The owner of multiple businesses will pay the full price of the highest BM Membership amount. Any additional businesses owned by the same owner will be discounted at 50%.

I am providing a direct deposit in the amount of $...

I am posting a cheque made out to Mudgee Chamber of Commerce for the amount of $...

**NOTE: NEW BANKING DETAILS FROM JANUARY 2023**
Direct Deposit Details:
Mudgee Chamber of Commerce
Westpac Banking Corp - MUDGEE
BSB: 032-653 Account Number: 143400
Please include your BUSINESS NAME & "Membership" for identification

Membership Application