Membership Details:

1. Membership Type:
2. Suite Desk
3. Monthly Rate:
4. Security Deposit:
   (monthly membership x1 for desk, x2 for suite)
5. Start Date:
6. Term:
7. Monthly Six Months One Year Other:

Business Details:

1. Business name of member:
   (to which invoices will be made)
2. Name of legal entity:
   (i.e. company name or full name of individual/names of partners)
3. Entity Type:
4. Individual Partnership Company/Incorporated association/Corporate trustee Unincorporated association
5. ABN:(required)
6. Website:
7. Telephone:
8. Mobile:
9. Fax:
10. Email:(valid email required)
11. Registered office of legal entity:
    (if an individual member, use your residential address. Companies and partnerships can use the Studio address. PO Boxes are not acceptable)
12. State:
13. Postcode:

Members postal address

1. As above
2. If different from the Hive Studio address:
   (PO boxes acceptable)
3. State:
4. Postcode:

Administrative Contact

1. Name:
2. Position:
3. Telephone:
4. Mobile:
5. Email:(valid email required)
6. Fax:

Billing Contact

1. As Above
2. Name:
3. Position:
4. Telephone:
5. Mobile:
6. Email:(valid email required)
7. Fax:

Business Description

1. What kind of work do you do?
2. Do you wish to have your business or organisation’s contact details on our members directory (signage, website, etc)?
3. yes no
4. click here for info on what is required to be included in our directory

Personal Details

1. (if someone other than or in addition to yourself will be using this membership, fill in the details at the end of this form for each person)
2. Family Name:(required)
3. First Name(s):(required)
4. Preferred Title:
5. Mr Ms Mrs Miss Dr
6. Current Address:(required)
7. State:(required)
8. Postcode:(required)
9. Home No:
10. Mobile No:(required)
11. Date of Birth:(required)

Additional Identification

1. Not required for employees
2. ID Type:(required)
3. ID #:
4. Issuing Body:
5. Expiry Date:(required)

Emergency Contact

1. Name:(required)
2. Relationship to you:
3. Telephone No:(required)
4. Address:

Additional Users
Person 1 (optional)

1. Family Name:
2. First Name(s):
3. Preferred Title:
4. Mr Ms Mrs Miss
5. Current Address:
6. State:
7. Postcode:
8. Email Address:(valid email required)
9. Home No:
10. Mobile No:
11. Date of Birth:
12. Emergency Contact
13. Name:
14. Relationship:
15. Phone No:

Person 2 (optional)

1. Family Name:
2. First Name(s):
3. Preferred Title:
4. Mr Ms Mrs Miss
5. Current Address:
6. State:
7. Postcode:
8. Email Address:(valid email required)
9. Home No:
10. Mobile No:
11. Date of Birth:
12. Emergency Contact
13. Name:
14. Relationship:
15. Phone Number:

Declaration

1. I hereby declare that the information provided is true and correct and any additional required information has been attached. Additionally, I understand I may have to undergo checks to determine my suitability for membership and entry into an agreement and will have to enter into such an agreement in order to commence membership.

 

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The personal information provided in this application form will be held in accordance with the Privacy and Personal Information Protection Act 1998. It may be disclosed to external organisations or individuals in instances where action relating to recovery of a debt owed. You are entitled to access and correct your personal information.