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NatRoad Membership Application Form

NatRoad's membership year runs from the 1 January 2011 to the 31 December 2011. If you join part way through the year, the subscription is calculated on a pro-rata basis. Please have a look at the table below for your pro-rata membership fee.

* Please note that we do not accept Bankcard or Diners Cards.  A 3% surcharge applies to memberships paid by American Express Cards.

Payment methods are:
Cheque, Visa, Mastercard, American Express or Bank Transfer to:

NatRoad Pty Ltd
BSB: 082 968
Account: 63 360 2159
Email remittance to: michael@natroad.com.au

To view the membership fees, go to: http://natroad.com.au/system/files/Membership%20Fees_0.pdf

Fill in the details below, hit submit and a NatRoad staff member will be in contact with you shortly.

NatRoad asks that you provide some minor details about your company.

This will enable NatRoad to develope accurate statistics to assist in our representations to Government and with our member services.

If you have selected other at the previous question please fill-in your details here.

If you have selected other at the previous question please fill-in your details here.

If you have selected other at the previous question please fill-in your details here.

You may already utilise the services of some of our supporters.

If so, please provide the relevant details so we can automatically register you as a NatRoad Member with these affiliates.

It you have purchased Thermo King Fridge Units, which state did you purchase them in?

Declaration

I have read/understood & in making application for membership, agree to NatRoad's Materials & Advice Disclaimer, the term & conditions outlined in NatRoad's Privacy Policy. I understand that terms of membership of NatRoad is governed by its constitution as amended from time to time. I declare that the information provided on this application is true & correct in every particular.
 
I HEREBY MAKE APPLICATION TO JOIN NATROAD LIMITED

PRIVACY STATEMENT

All information on this form is collected in accordance with our Privacy Policy. By taking out membership, unless you indicate otherwise, you agree that we may use your personal information (contact details) and disclose it to our business partners (NatRoad Foundation Partners and NatRoad Supporters) to give you information and offers about products and services by us or these companies.  IF YOU TICK THIS BOX YOU WILL BE INELIGIBLE FOR ANY DISCOUNTS OR OFFERS FROM OUR PARTNERS AND SUPPORTERS THAT REQUIRE US TO VERIFY YOUR MEMBERSHIP.