Join ACEN

ACEN Membership - Registration Form

Membership information collected here may be provided to ACEN state chapters and organisers of ACEN events solely for the use of providing information about those events.

         
  * First Name:    
         
  * Last Name:    
         
  * Email:    
         
  Title:    
         
  Position:    
         
  * Organisation name:  
 
         
  Organisation website:    
         
  * Mailing address:    
         
  * Suburb:    
         
  * Postcode:    
         
  * State:    
         
  * Country:    
         
  * Phone number:  
 
         
  Mobile number:  
 
         
  Fax number:    
         
  Area / Discipline
(eg. engineering, marketing, careers)
   
         
  Please indicate your area of interest:  




 
         
  Other interests:    
         
  Please write a short summary of your current role:    
         
  * Membership category   Institutional - Full ($2,200 p.a. inc GST)
Institutional - Limited ($1,100 p.a. inc GST)
Individuals ($275 p.a. inc GST)
Affiliate (no fee - newsletter only)
My institution is a member of ACEN and I wish to be registered
under that membership (no fee)
 
         
         
       
         

© 2011 Australian Collaborative Education Network Inc. All rights reserved.