Potential Members

MEMBER APPLICATION FORM

1. Company Details

Company:

Physical Address 1:

Physical Address 2:

Physical City:

Physical State:

Physical Postcode:

Postal Address 1:

Postal Address 2:

Postal City:

Postal State:

Postcode:

Company Phone:

Website:

Company Email:

2. Primary Contact Person

Please nominate a primary contact. This person will be set up with full access in Business Events
Perth’s CRM system, Simpleview, and will be able to manage your company account including
setting up other contacts, permissions, listings, managing leads, etc. This person will also be
Business Events Perth’s first point of contact.

Full Name:

Position:

Primary Phone:

Mobile Phone:

Email:

3. General Manager/Managing Director

Contact Name (Manager):

Position (Manager):

Direct Phone (Manager):

Mobile (Manager):

Email (Manager):

4. Nominated AGM Voter

A representative within the organisation to vote at Business Events Perth's AGM (not applicable to non-financial virtual members)

Contact Name (AGM Voter):

Position (AGM Voter):

Mobile (AGM Voter):

Direct Phone (AGM Voter):

Email (AGM Voter):

5. Membership Level

hidden label

MEMBERSHIP TIER

Accommodation (on formula)
Platinum
Gold
Silver
Bronze
Affiliate*
Regional: Refer to Partnership Prospectus

6. Membership Categories

hidden label

VENUES & ACCOMMODATION

Apartments
Convention and Exhibition Venue
Function Rooms
Hotels

Hotels with Meeting Space
Restaurants
Unique Venues
Winery/Brewery

7. Application Submission

Main Contact:

Signature Name:

* Indicates a required field.

Please enter the 4 character string shown in the box above.

Submit Reset

Collection Statement

The information collected on this form will be used for the purpose of assessing your organisation's request to become a member with Business Events Perth. Should you want to view any personal information retained by Business Event Perth, or you require further details on the privacy policy, or you wish to exercise any of your individual rights that are available to you, please contact our Director Corporate Services on + 61 (0) 8 9218 2900.