CMSA Individual Membership Application

Case Management Society of Australia Inc. (No. A0034642S)

Level 6-52 Collins St
Melbourne VIC 3000
Phone: 03 9658 2399 Fax: 03 9658 2388

Email: cmsa@cmsa.org.au
Website http://www.cmsa.org.au
ABN: 53 782 362 507

Please complete the following information exactly as you desire it to be included in the CMSA Membership Directory

Please print legibly

New Membership Renewal

Preferred mailing address:

Home Work

Name

Date

First Last

Qualification(s)

Email

Mailing address

Suburb

State

Postcode

Country

Employer

Job title

Employer address

Suburb

State

Postcode

Work Phone

Fax

Which of the following best describes your special interest? (Tick all that apply)

Education

Acute care

Community care

Corrections

Disability services

Employment

Insurance

Mental health

Protective services

Rehabilitation

Other

Number of years in CM:

0-3 4-6 7-10 Over 10

Membership dues for CMSA are

Individual: $212 per year (inc GST)

Full-time Student: $159 per year (inc GST)

TAX INVOICE

Method of payment

Cheque

or money order (enclosed) Amount enclosed $

Australian dollars)

Cheques should be made payable to "CMSA"

Credit Card	Card Type : Visa Mastercard
Card Number
Expiry Date	/	CardHolder Name
Signature

FOR OFFICE USE ONLY:

Date received;..............................	Receipt number:......................
Date banked................................	Date receipt sent......................

Welcome to the Case Management Society of Australia

Strength in Numbers

Case Management Society of Australia has hundreds of members. More members means more knowledge. More knowledge means more power. More power means we expand our resources, augment our community linkages and strengthen our presence.

Your Influence on the Future

Your active Individual Membership in CMSA allows you to influence the future direction and development of case management as a profession.

Through your membership you can participate in this international organisation, helping to promote its goals and mission, while receiving exposure at both a national and international level for you and your organisation.

There are three categories of membership catering to the size and needs of all individuals and organisations. The categories and benefits of membership are listed below:

Please note that all prices are inclusive of 10% GST

INDIVIDUAL MEMBER CATEGORY

Cost $212 annually ($159 full time students)

Individual membership

Corporate Membership Level 1

Cost $1,120 annually

Provides 6 individual memberships for your organisation

Corporate Membership Level 2

Cost $1,755 annually

Provides 10 individual memberships for your organisation

Corporate Membership Level 3

Cost $2,966 annually

Provides 18 individual memberships for your organisation