Membership Application Form - Monash Precinct Network

Apply for Membership of Monash Precinct Network

Please complete and submit this application to join Monash Precinct Network. Upon approval by the Monash Precinct Network Board, we will contact you for payment and request information to promote your organisation on our website and on social media. Membership of Monash Precinct Network covers all employees in your organisation and enables you to participate in exclusive member activities, and purchase tickets to events at member prices.

Organisation Details

Organisation Name *
Country*
Street *
Suburb *
State/Region/Province *
State *
Postcode *

Mailing Address Details

Mailing Address is same as above

Country *

Street *

Suburb *

State/Region/Province *

State

Postcode

About Your Company

Company Website *
Company Phone *
Industry*
Number of Employees *
Number of Employees over 101 *
Membership Selection *
Membership Rate
$
Please give a short description about your organisation and the innovative work you are doing. *
If you would like to attach any supporting documentation, such as annual reports, press releases or project reports, please do so here.
What are your goals for membership of Monash Precinct Network? *

Primary Contact

Please provide details for an executive level contact in your organisation. They will receive key member communications and be listed on our website as your organisations key contact.

Title *
First Name *
Last Name
Position *
Phone Number *
Email *

Secondary Contact

I wish to add a secondary contact

Accounts Contact

I wish to add a account contact

Declaration

By submitting this form, you are confirming your wish to join Monash Precinct Network. You are agreeing to follow the rules and policies of Monash Precinct Network.

I agree to the Terms & Conditions *

Fee by negotiation and may vary. We will advise you following your application review.

MembershipApplication Form