IRCA Membership Application
I certify that the nominated organisation/I meet the eligibility requirements relevant to the membership category indicated above. I understand that this application is subject to approval by the IRCA Board and that further information may be requested to support this application. For organisations, the further information may include a Constitution/Rule Book and/or Strategic Plan and/or Annual Report. I understand that the IRCA Board holds the final decision regarding membership approval and eligibility.
In applying for membership of IRCA, I declare that the applicant agrees with the Objects of IRCA and that its representatives will abide by the membership policies set out on the IRCA website at irca.net.au/membership
Application: Organisation or Individual
Select the membership category you are applying for. If in doubt please check
for further information.
Ordinary member representative
Friend of IRCA membership
First Name (Organisation Contact or Individual)
Last Name (Organisation Contact or Individual)
Organisation Name (if applicable)
Please check the status that you or the organisation identifies with.
Aboriginal and Torres Strait Islander
ABN (for organisational membership applications)
Legal Status of Organisation (for organisational membership applications)
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
Address inc street name and number, suburb, state and postcode
Mailing Address (if different to above)
Please provide a description of your media work or relationship to the media industry.
FOR ORDINARY MEMBERSHIP APPLICATIONS PLEASE PROVIDE DETAILS OF YOUR NOMINATED VOTING REPRESENTATIVE
The Voting Representative is to be an Aboriginal/Torres Strait Islander person aged 18 and above who would be eligible for Associate Membership (that is actively working in the media industry)
Voting Representative Name (For Ordinary membership only)
Position held by Voting Representative
Voting Representative mailing address (For Ordinary membership only)
Voting Representative primary phone number (for Ordinary membership only)
Voting Representative email address (for Ordinary membership only)
Please upload a signed "Signature for IRCA Membership" form, or alternatively sign the form and fax to IRCA on 08 8992 9669 or email to firstname.lastname@example.org or post to IRCA at IRCA PO Box 2731 Alice Springs NT 0871 within a week of your online application.
Send me a copy of my responses
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