Application for Associate (Organisational) Membership of IRCA
I certify that the organisation for which I am making application meets the eligibility requirements for Associate (Organisational) Membership of IRCA being an Aboriginal and Torres Strait Islander not-for-profit organisation that produces media outside of the core constitutional objectives of the organisation.
In applying for membership of IRCA, I declare that I agree with the Objects of IRCA and that I and the relevant representatives, including the Associate Membership Representative, 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 Associate (Organisational) membership is $165 inc GST, and that I will be issued with a Tax Invoice where this membership application is approved.
Some fields below are prefilled. Please do not modify.
Ordinary member representative
Friend of IRCA membership
Organisational Associate Members are to be Aboriginal and Torres Strait Islander organisations.
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 name and number, suburb/city/community, State/Territory, postcode
If the same as the Street Address please note "Same as street address"
Primary contact First Name
Primary contact Last Name
Primary contact Position Title
Primary contact Email Address
Primary contact Phone Number
Primary contact Mobile Phone
Aboriginal and Torres Strait Islander Associate Membership Representative (non-voting)
The person is to be an Aboriginal and Torres Strait Islander person aged 18 years and over and otherwise eligible for Associate Membership of IRCA. This person is the primary person engaging in IRCA General Meetings, and may the same person as the primary contact. If so please note "same as primary contact person".
Associate Membership Representative Position Title
Associate Membership Representative mailing address
Please note "same as organisation" where relevant
Associate Membership Representative email address
Associate Membership Representative primary phone number
Please check this box if you wish to be placed on the IRCA Newsletter mailing list
Please provide brief information about the activity of your organisation
Please upload your signed Signature for IRCA Membership form if possible. Otherwise please fax to IRCA on 08 8992 9669 or email to firstname.lastname@example.org or post to IRCA PO Box 2731 Alice Springs NT 0871, within a week of your application.
Send me a copy of my responses
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