subject_line
MEMBERSHIP APPLICATION
Business Name
*
Owner / Mgr name
*
Street Address
*
Suburb
*
State
*
NT
SA
QLD
WA
NSW
VIC
Zip Code
*
Phone Number
*
Email Address
*
BUSINESS LISTING
The following fields will be used to populate your business listing on the Northam Chamber of Commerce website. If they change at any time please advise us so they may be updated.
Contact name - Business Listing
Phone Number
Website
Facebook address
🛈
Email Address - Business Listing
Business Profile (max 255 characters)
Further information on your business (optional)
Please upload 3 images for your business profile.
ANNUAL MEMBERSHIP FEE
Membership rates
*
No Charge - Businesses that pay the Differential rate to the Shire of Northam (Your rates notice will show ‘Differential rates’)
$99 - Any Business located within the Shire of Northam
$195 - Any Business located outside of the Shire of Northam but with business operations within it.
$25 - Associate Membership - Individuals (For Individuals with no registered business)
$45 - Associate Membership - Group (eg Community Groups)
Membership fees may be paid by EFT or cash deposit to the following account:
Bank:
Commonwealth Bank
Account name:
Northam Chamber of Commerce
BSB:
066 524
Account Number:
1016 9419
REF:
Please use your Business Name
Please accept the following conditions prior to submission
*
I agree to my email being added to the NCC mailing list for newsletters and other relevant communication
I agree to my business listing on the Chamber website for promotional/marketing opportunities.
I agree to my contact details being shared with CCIWA so that I am able to access the facilities offered as part of my membership with the Northam Chamber of Commerce and Northam Women in Business.
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