Name of Company Postal Address Street Address Company Website Nature of Company/Business MEMBERSHIP CATEGORY MEMBERSHIP CATEGORY Full Member ($2,000 per annum including GST for all countries) Limited Member ($1,350 per annum including GST for up to 3 countries) Associate Member ($800 per annum including GST for 1 country) Member's Representative to the Council Member's Representative to the Council I wish to apply for membership of the Australia Pacific Islands Business Council in the membership classification indicated above. First Name Last Name Designation Position Telephone Email Address Please indicate countries of interest if registering as Multiple or Single Country Member Please indicate countries of interest if registering as Multiple or Single Country Member American Samoa Cook Islands CNMI Federated States of Micronesia French Polynesia Guam Kiribati Nauru New Caledonia Niue Palau Republic of The Marshall Islands Samoa Soloman Islands Tokelau Tonga Tuvalu Vanuatu Wallis and Futuna How did you learn of the council? How did you learn of the council? Event Colleague Web Other If others, please specify Send Application
