Membership Application

Member Information

Title

First Name (required)

Last Name (required)

Business Name (required)

Business Address (required)

Business Phone Number (required)

Mobile (required)

Business Email (required)

Business web address

Products or services your business offers

Operating hours

Your busy times of the year

Your quiet times

Would you be happy to contribute your time to help organise some StawellBiz events?
YesNo

What can Stawellbiz do that would be of benefit to your business?

We are setting up a mentoring program to help member business reach their full potential. Do you have skills in an area that would benefit other businesses in this program or would you like to spend some time with one of our mentors

I agree to abide by the terms and conditions of StawellBiz

Membership Fee

$100.00 per year, due 31st July each year.
Electronically to: Account name: StawellBiz BSB: 063 528 Account No: 1028 2643
Cheques to be made payable to StawellBiz and forwarded to:
StawellBiz, PO Box 712, Stawell Vic 3380.

If you experience difficulty with our on line form, you can download a PDF version of the StawellBiz membership form here! pdficon_large