Application for Affiliate (Organisational) Membership of IRCA
I certify that the organisation for which I am making application meets the eligibility requirements for Affiliate (Organisational) Membership of IRCA being a non-Aboriginal and Torres Strait Islander not-for-profit organisation that engages directly with the Aboriginal and Torres Strait Islander media industry.
In applying for membership of IRCA, I declare that I agree with the Objects of IRCA and that I and any relevant representatives will abide by the membership policies set out on the IRCA website at
I understand that:
* For this online application to be progressed it needs to be accompanied by a signed "Signature for IRCA Membership" form (
). The signed form may be uploaded with this online form or emailed, posted or faxed separately as per the information on the form.
* This online application is subject to approval by the IRCA Board and that further information may be requested to support this application.
* That the IRCA Board holds the final decision regarding membership approval and eligibility.
I understand that the annual fee for Affiliate (Organisational) membership is $22 inc GST, and that I will be issued with a Tax Invoice where this membership application is approved.
Some fields below are pre-filled. Please do not modify.
Ordinary member representative
Friend of IRCA membership
Aboriginal and Torres Strait Islander?
Non-Aboriginal and Torres Strait Islander?
Legal Status of Organisation
Company limited by guarantee (ASIC registered)
Propriety Limited Company Limited by Shares (ASIC Registered)
Association or cooperative registered under State or Territory legislation
Business or other for-profit organisation
Street address of organisation
Street and number, suburb/city/community, State/Territory, postcode
Mailing address of organisation
If the mailing address is the same as the street address please note "Same as street address".
First name primary contact person
Last name primary contact person
Position title primary contact person
Email address primary contact person
Phone number primary contact person
Mobile phone of primary contact person
Tick if you wish to be on the IRCA Newsletter mailing list
Please provide relevant information about the activities of your organisation in relation to the Aboriginal and Torres Strait Islander media industry.
Please upload your signed Signature for IRCA Membership form if possible. Otherwise please fax to IRCA on 08 8992 9669 or email to email@example.com or post to IRCA PO Box 2731 Alice Springs NT 0871, within a week of your application.
Send me a copy of my responses
Your submission is being processed. Please do not close this browser window until complete.