Social Enterprise Cooperatives and Mutuals 

REGISTRATION FORM

SOCIAL ENTERPRISES
 COOPERATIVES AND MUTUALS

There are two categories of membership:
A. Enterprises
    B. Entrepreneurs  


A. ENTERPRISES

Name of enterprise


Name of contact person

Position held by contact person

Contact email  

Phone  (bh)     Phone (ah) 

Organisation Address
  


  We would like to join Social Enterprises Cooperatives and Mutuals
as a:


  Social enterprise
  Cooperative        
  Mutual               



Tell us about your business and your purpose


Are you an independent business?

Have you traded for a minimum of one year and do you earn 50%
or more of your income from trading?

Are you owned by your members or do you allocate a significant proportion of your profit for social or community or environmental benefit?

There is a membership fee of $30 per annum to Social Enterprises Cooperatives and Mutuals*

* This fee is waived for organisations which are members of Civil Society Australia.


B. ENTREPRENEURS

Name of entrepreneur


Position held

Contact email  

Phone  (bh)     Phone (ah) 

Organisation Address
  
  


  I would like to participate in Social Enterprises Cooperatives and Mutuals.



Tell us what makes you an entrepreneur in this area:



LEADERSHIP GROUP

  I would like to express an interest in joining the Leadership Group.

Name of individual


 

Tell us about your interest in being part of the Group:


 

  I understand that the Membership Fee is $30 (unless the
organisation is a member of Civil Society Australia)
.
Payment is required with this registration.

I will
  pay by EFT
  forward a cheque by mail
  Please send a tax invoice for payment to Social Enterprise
Partnerships Ltd.
ABN: 47 108 742 098

Payment Options:
EFT
(Commonwealth Bank of Australia  Account name: Social Enterprise Partnerships Ltd
BSB: 062 218  Account number: 1007 2945)

Cheque
(
payable to Social Enterprise Partnerships Ltd, mail to PO Box 159 Yarraville Vic 3013)
 


 

  Civil Society Australia 2015