2020 JLTAV Individual Membership Application Form

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The Japanese Language Teachers' Association of Victoria Inc.
LPO Box 8157, 12 Ancora Imparo Way, Monash University VIC 3800

TAX INVOICE - ABN 29 370 901 218
Date: email date
Number: 2-3/2020

1. Complete this online form, and submit it. Ensure that both email addresses are correct.

2. Print it before you press "SUBMIT". This application form becomes a TAX INVOICE for the payment purpose for your school. (This will also be emailed to you.)

3. EFT to BSB 033-034 A/C# 61-1599
Account name: Japanese Language Teachers Association of Victoria Inc
(Please send payment advice to jltav@jltav.org.au. No paper advice required.)

Payment enquires to: jltav@jltav.org.au

Email *

Confirm email address *

Your name *

Select membership category *

All fees include GST. Amounts in ( ) show early bird rate, apply if received by 29/2/20)

$30.00 ($25.00) Full time student - Photocopy of 2020 Student ID must be sent to us

$30.00 ($25.00) CRT

$72.00 ($65.00) Individual OR only one teacher of Japanese at a school

Required

School Purchase Order Number (if applicable)

School name *

If you don't work for a school, write CRT, Tutor or Student.

School sector *

School location *

School or home street address *

School or home suburb/town and state *

In capital letters, e.g. CLAYTON VIC

School or home postcode *

School telephone number or your mobile number *

Without spaces, e.g. 0399058791

Please check before submitting

1. Double-check this form.
2. Don't forget to click SUBMIT after printing. Click only ONCE.
3. Membership is accepted when we receive the payment.
4. A confirmation email will be sent to the email address you specified immediately. Please check your inbox for notification to ensure you entered your details correctly. Check spam folders if necessary.
5. If you did NOT receive a confirmation email, you either did not complete the form or entered your email address incorrectly. This will likely mean you are not registered.
6. You MUST resubmit the form if you did not receive a confirmation email within five minutes.

A copy of your responses will be emailed to the address you provided.

Submit

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