Membership Form

Strong and Capable Cooperative Membership Form

Please fill out this form if you would like to become a member of the strong and capable cooperative. Once completed and all the terms are accepted we will send you or your plan manager an invoice for the membership fee.

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* 1. Member Details

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. I am...

Person with disability

Primary carer

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* 3. I consent to Strong & Capable to use this email address for official notices. If no, Strong & capable will send all official notices to you by hard copy post e.g. notices for AGM

Yes

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* 4. I prefer to receive communication from Strong & Capable by;

Text

Post

Other (please specify)

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* 5. What is your primary language?

English

Auslan

Other (please specify)

I agree to accept the Active membership requirements in accordance with Rule 4.2 of the Rules of the Cooperative.

These are:

Pay an annual fee
Agree to actively use one service provided by Strong & Capable during each financial year (July – June) in which a Member is a member of the Cooperative

The annual membership fee is Fifty dollars ($50.00). This could be charged to a member’s NDIS Plan.

We are happy to accept donations.

Please send through your $50 membership fee to the below bank details or notify us to send invoice to your plan manager.

Bank Account Details BSB Number: 325-185
Account Holder Name: Strong and Capable
Account Number: 03904640

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* 6. Please send the invoice for the membership fee

Via Email

Via Post

Or, please send the invoice to me plan manager. Please provide details below.

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* 7. I agree to the above membership requirements

I agree