CEASA Corporate Membership Online Application Form
Company Name
Company Registration Number
Postal Address
Postal Code
Physical Address (Only one required)
Telephone Number Including Area Code
Fax Number Including Area Code
Email Address to use for Association Notices
Company Logo (For Email or website linking. Please email your logo to
the webmaster
)
I Will Email A Company Logo
Logo can be found on our URL
I Need Help With A Logo
Website Address (If not available, the Email address provided above will be linked to your logo.)
Please provide us with a maximum of three descriptive sentences to be placed under your CEASA website logo.
If known, please provide us with the names of Individual CEASA members whom are employed by the Company. (If none, please advise "Nil")
Declaration and Administration
Name of Person Submitting This Application
Cellular Phone Contact Number
The Company agrees to abide by the Constitution
Yes
No
Proposing CEASA Member (If none, leave blank)
Seconding CEASA Member (If none, leave blank)
