AUC Membership Application (Institution)

This is the application form for institutions. Please complete the details on the form. Once your application is approved, you will be contacted with payment instructions.

Please note: This person identified as the AUC Coordinator on this form will normally be considered to be the person who gets to cast the member’s vote(s) at general meetings, and this person will be regarded as the primary contact by the AUC for issues related to the member. Please ensure that you have the appropriate authority to commit your institution to membership of the AUC before submitting this application.

Date

Applicant Given Name *

This is the person who is authorised to apply for membership on behalf of their institution, and to whom the membership invoice will be sent.

Applicant Family Name *

Applicant Email *

AUC Coordinator Given Name *

The AUC Coordinator is the person who represents the AUC at their institution. Their contact details will be published on the AUC web site, and they are expected to promote AUC programs on campus, and distribute registration discount codes to staff who wish to register for AUC events.

AUC Coordinator Family Name *

AUC Coordinator Email *

AUC Coordinator Telephone Number *

Membership Type *

Institution

Department/Faculty/School (or similar unit)

University *

University (Other) *

If you've chosen "other" for your university affiliation, please provide the name of your institution here.

Department/Faculty/
School Name *

For non-institutional membership applications, please provide the name of your department/school/faculty or similar organisational unit.

Payment Preference *

Paypal or credit card (MasterCard or Visa)

EFT (Direct transfer from Australian accounts only)

Are you Human?