Membership Renewal

To renew your annual subscriptions to ACTIV please read these instructions fully before completing the on-line form.

1. Complete the on-line form and press submit.

2. These details will automatically be forwarded to ACTIV.

3. Confirmation of the details submitted will appear in a Renewal Advice Form.

4. If paying by DIRECT TRANSFER please print one copy of the Renewal Advice Form and retain for your records. Once you have paid we recommend you note your receipt number on this form.

5. If paying by CHEQUE please print two copies of the Renewal Advice Form. Retain one for your records. Forward the other copy, along with your payment to

ACTIV Inc.
GPO Box 2359
Melbourne Victoria 3001

Direct Transfer Instructions

If you have access to internet banking, membership may be paid by directly transferring money from your personal account into ACTIV's cheque account. Follow the instructions on your banking website for an external transfer of money.

NOTE: Be sure to type your name or membership number where prompted to provide a unique identifier (reference/description etc) in order that ACTIV can track payments.

Complete the form below and check the Direct Transfer box.

Once payment is completed your bank will provide you with a receipt number. It is very important you keep a record of this as proof of payment. ACTIV's account details are as follows.

BSB: 06 3001
Account number: 10098760
Account name: Association of Cardiac Technology

Your Details:
Title:
First Name:
Last Name:
Address:
Address 2:
City/Suburb:	State:
Postcode:
Contact details:
Home Phone:
Work Phone:
Mobile Phone:
Fax:
E-Mail:
Occupational Details:
Current Education Standard:
Years in the Field:
Place of Employment:
Present position(s) held:
Full Time Part Time
On Extended Leave: Yes No If yes, number of years
Retired: Yes No
Membership Details:
Membership Number:
Present Classification:
Do you wish to be reclassified? Yes No
If yes, please provide supporting details for re-classification:

Classification for this renewal: (Click on level for explanation)
Full Member		$50.00
Full Member (early-bird)		$45.00
Associate Member		$40.00
Associate Member (early-bird)		$35.00
Affiliate Member		$30.00
Affiliate Member (early-bird)		$25.00
Corporate Member		Cost on application
Do you wish to receive Tech Info newsletter by mail or email?
Method of Payment
Cheque
Direct Transfer

Please press submit and print two copies of the Membership Renewal Advice and forward one copy with your cheque for the above amount to the address indicated on the membership renewal advice.

Classification

Full Members

Cardiac Technicians and Cardiac Technologists who have at least three years fulltime experience or equivalent and are currently working or have worked in the field during the last three years.

Early-bird

Available to all member classifications paying by January 14. If paying by cheque, envelope must be postmarked January 14 at the latest. If paying by direct transfer, money must be transferred to ACTIV cheque account by midnight January 14 at the latest.

Associate Members

Cardiac Technicians and Cardiac Technologists who have at least one year fill-time experience or equivalent and are currently working or have worked in the field during the last three years but are not yet eligible for Full Membership.

Affiliate Members

Cardiac Technicians and Cardiac Technologists who have not worked in the field during the last three years, or are now engaged in commerce or industry, or have permanently retired, or do not reside in Victoria. Organisations and individuals with a professional interest in Cardiac Technology.

Corporate Members

ACTIV welcomes corporate membership from interested companies. For further information and application please contact info@activinc.org.au.