Associate Membership - Fraser Coast FM 107.5

Associate Membership Form

Use this form to apply Associate Membership or to update organisation contact details.

"*" indicates required fields

Is this a new membership or update? Note: Membership is renewable each financial year.*

Annual subscription can be paid by Credit card or by direct bank transfer to: Fraser Coast Community Radio Inc. BSB: 633 000 Account No: 162 781 850 Ref: Your NFP Name

Payment Method

Credit Card

Bank transfer

Name of Not for Profit Organisation*

ABN

Main Contact person – full name*

Main Contact Phone

Office Phone Number

Accounts Contact – full name*

Accounts Contact Number*

Accounts Email*

Invoices will be sent to this email address.

Registered Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Venue Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Description of Activities for Website Listing*

This description will be included on our website Community Hub page and should include the purpose of the organisation. Also details of regular member meetings/events/activities and a venue, time and contact number.

Script for On Air Promotion 70 words(30 second limit)

This promotional message is for the purpose of raising awareness for your organisation and should include services offered, regular meeting dates and contact details. We will produce a 30 second recorded promotion for regular airplay during available time. We offer an annual update of the recording once a year coinciding with your annual membership renewal. Please complete the attached form to provide us with your script. If you have somebody within your organization with a voice for radio, we invite you to have that person do the voiceover for your recording. This can be arranged by contacting us during office hours (Mon-Thursday 9am-12pm). Alternatively, one of our presenters will record your message.

President Name*

Email*

Treasurer Name*

Email*

Secretary Name*

Email*

Event Organiser Name

Event Organiser Contact Number*

Email*

Pay by Credit Card $80 (financial year)

Price:

Leave this field blank if you are paying by bank transfer. We will send an invoice/receipt on receipt of your payment.

Total

Card Details

This field is for validation purposes and should be left unchanged.