International Membership

Submit a membership application for the period

1 July 2020 to 30 June 2021

International Membership Form

Name*
Prefix First Last
Firm
I wish to:*
- Renew my membership for the financial period 2020 / 2021
- Join the Society for the financial period 2020 / 2021
Address*
Street Address City State Postcode Country
Phone/Mobile
Email*
Hardcopies of the IPSANZ journal
IPSANZ’s journal, Intellectual Property Forum, is circulataed to members electronically. Should you wish to continue to receive Intellectual Property Forum in hardcopy, please mark this box.
- Yes, I wish to receive Intellectual Property Forum in hard copy
Emails of IP related information to members
IPSANZ does not provide details of its members to third parties. IPSANZ is from time to time approached by third parties to distribute materials to its members. If IPSANZ considers the material to be IP related and of potential interest to members, it will electronically distribute such material. Please indicate below if you DO NOT wish to receive such third party material.
- No, I do not wish to receive third party emails circulated by IPSANZ
Membership category:*
Additional memberships
- Would you like to register additional members to this address?
List*
Prefix First Name Last Name Email Member Type Phone/Mobile Hard Copies Third Party
Memberships:
International
Price: $ 160.00 Quantity:
Total Price in AUD
$ 0.00
Payment method:*
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Please return this registration with your cheque/draft in AUSTRALIAN DOLLARS made PAYABLE TO IPSANZ or payment can be made by EFT (details below):

IPSANZ
GPO Box 2491
Melbourne VIC 3001
T: 61 3 9761 2833
M: 0409 016 790

Payment by electronic transfer:

Bank account details:
Bank: Commonwealth Bank of Australia
221 William Street, Melbourne
Account Name : The Intellectual Property Society of Australia and New Zealand (IPSANZ)
BSB No: 063 009
Account No: 0090 3138
Swift : CTBAAU2S

Please provide remittance upon transfer
You will be prompted to pay by credit card after submitting this form.

We will contact you once payment has been confirmed, or if there are any issues. Your details will be recorded even if the credit card payment is unsuccessful so no need to register again. Feel free to contact us directly if you have any concerns.

Membership Application

Membership will not be valid until payment is received.

Once membership has been processed, members will receive confirmation of membership.

The Secretariat
I.P.S.A.N.Z
G.P.O. Box 2491
Melbourne Vic. 3001
Email: ipsanz@ipsanz.com.au
Telephone: 61 3 9761 2833

I.P.S.A.N.Z.
A.R.B.N. 056 252 558
A.B.N. 66 056 252 558

Prefix	First Name	Last Name	Email	Member Type	Phone/Mobile	Hard Copies	Third Party

International Membership

Submit a membership application for the period

1 July 2020 to 30 June 2021

International Membership Form

Memberships:

Membership Application

IPSANZ

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