AUSTRALIAN INSTITUE OF HORTICULTURE Inc NEW MEMBERSHIP APPLICATION FORM FOR: GENERAL MEMBER- GENERAL MEMBER WITH REGISTERED HORTICULTURIST (RH) ACCREDITATION ASSOCIATE MEMBER - STUDENT MEMBER - GRADUATE MEMBER, MEMBER UPGRADE TO ACCREDITED REGISTERED HORTICULTURIST (RH), SINGAPORE CPH MEMBER - RETIRED MEMBER - OVERSEAS MEMBER FULL NAME MEMBERSHIP AIH General Member upgrading to General Member MAIH) General Member with CATEGORY & COST Accredited Registered Horticulturist Registered Horticulturist $330 pa plus one off Joining pa (MAIH, RH) Accreditation fee of $110 (AUD$) $550 one off and Standard RH annual (MAIH, RH) Associate Member (AAIH) fee thereafter (please circle) $440 pa plus one off $230 pa plus one off joining Admin Fee $220 Fee Incl GST Overseas RH AUD Singapore CPH AUD $175pa Graduate Student $77pa $400pa plus $200 joining Student Member FREE to June 30th 2018 Grads up to 2 years Overseas General Retired General Member $110pa No Joining Fee No Joining Fee AUD $300pa plus $100 (No Joining Fee) Joining Fee ADDRESS STATE SUBURB /CITY POSTCODE POSTAL ADDRESS COUNTRY OCCUPATION/INDUSTRY SECTOR PHONE (BUS HRS) MOBILE EMAIL ADDRESS WEBSITE ADDRESS Issued by and Year: QUALIFICATION: (Highest achieved) Documented industry Attached: **ASSOCIATE: experience YEARS IN INDUSTRY Areas of Specialisation SUPPORTING DOCUMENTATION (attach to your application form) Full Member: Copies of relevant qualifications Minimum Cert 3 Hort or Accredited Registered Horticulturist (RH) Passport size photo graphic file of clear headshot. Associate: Relevant Five (5) years industry experience details Professional experience proforma Professional Indemnity Insurance Cert. of Currency Student: Proof of your current training Existing AIH Member upgrading to RH Membership No._______________ Graduate: Copy of relevant qualification PAYMENT OPTIONS: 1. Electronic Funds Transfer (see below) 2. Credit Card (page 2) 3. via aih.org.au 4. Invoice Account Name: (if different to applicant): ELECTRONIC FUNDS TRANSFER: Bank Bank: Westpac Banking Corp Account Name: Australian Institute of Date Paid and Horticulture Inc Receipt No. BSB: 034077 Account No: 380916 CREDIT CARD: VISA MASTERCARD Expiry Date / CSV
AUSTRALIAN INSTITUE OF HORTICULTURE Inc NEW MEMBERSHIP APPLICATION FORM FOR: GENERAL MEMBER- GENERAL MEMBER WITH REGISTERED HORTICULTURIST (RH) ACCREDITATION ASSOCIATE MEMBER - STUDENT MEMBER - GRADUATE MEMBER, MEMBER UPGRADE TO ACCREDITED REGISTERED HORTICULTURIST (RH), SINGAPORE CPH MEMBER - RETIRED MEMBER - OVERSEAS MEMBER FULL NAME MEMBERSHIP CATEGORY & COST pa (AUD$) (please circle) Incl GST General Member MAIH) $330 pa plus one off Joining fee of $110 Associate Member (AAIH) $230 pa plus one off joining Fee General Member with Registered Horticulturist Accreditation (MAIH, RH) $440 pa plus one off Admin Fee $220 AIH General Member upgrading to Accredited Registered Horticulturist (MAIH, RH) $550 one off and Standard RH annual fee thereafter Student Member FREE to June 30th 2018 No Joining Fee Graduate Student $77pa Grads up to 2 years No Joining Fee Overseas RH AUD $400pa plus $200 joining Overseas General AUD $300pa plus $100 Joining Fee Singapore CPH AUD $175pa Retired General Member $110pa (No Joining Fee) ADDRESS SUBURB /CITY STATE POSTCODE POSTAL ADDRESS COUNTRY OCCUPATION/INDUSTRY SECTOR MOBILE PHONE (BUS HRS) WEBSITE ADDRESS EMAIL ADDRESS QUALIFICATION: (Highest achieved) Issued by and Year: **ASSOCIATE: Documented industry experience Attached: YEARS IN INDUSTRY Areas of Specialisation SUPPORTING DOCUMENTATION (attach to your application form) Full Member: Copies of relevant qualifications Minimum Cert 3 Hort or Associate: Relevant Five (5) years industry experience details Student: Proof of your current training Graduate: Copy of relevant qualification Accredited Registered Horticulturist (RH) Passport size photo graphic file of clear headshot. Professional experience proforma Professional Indemnity Insurance Cert. of Currency Existing AIH Member upgrading to RH Membership No._______________ PAYMENT OPTIONS: 1. Electronic Funds Transfer (see below) 2. Credit Card (page 2) 3. via aih.org.au 4. Invoice ELECTRONIC FUNDS TRANSFER: Bank: Westpac Banking Corp Account Name: Australian Institute of Horticulture Inc BSB: 034077 Account No: 380916 Account Name: (if different to applicant): Bank Date Paid and Receipt No. CREDIT CARD: VISA MASTERCARD Expiry Date / CSV
AIH-Membership-Appn-020318.docx