PRIVACY POLICY
MEAA.ORG
#MEAAequity
DIRECT DEBIT
PERSONAL DETAILS
PREVIOUS MEMBERSHIP
Surname
Yes
Given names
Branch
Years
Professional name
Title
Mr
Gender
Ms
Female
Mrs
Miss
STATEMENT
Other
I hereby make application for membership of the Media, Entertainment and Arts
Alliance (and its related state registered unions where they exist) and agree to
be bound by its rules and constitution as amended from time to time.
Male
Date of birth __ __ / __ __ / __ __ __ __
I am an Australian citizen/resident
Yes
No
Yes
No
(optional)
Postcode
Home phone
Work phone
Mobile phone
No
Signature
Date
METHOD OF PAYMENT
Direct Debit (see right)
Preferred email
To pay your fees by periodic credit card deduction fill in this form.
Please charge my credit card for membership fees:
Other email
Twitter
weekly
fortnightly
monthly
Website
quarterly
half-yearly
annually
Current Agent
Mastercard
Type of work
Visa
/
Insert name and address of financial institution at which your account is held
I/We
surname or company/business name
request you until further notice in writing debit my/our account described in
the schedule below any amounts which Media, Entertainment & Arts
Alliance ABA No 063704 may debit or charge me/us through the Direct Debit
System. I/We understand and acknowledge that:
1. The Financial Institution may, in its absolute discretion, determine the
order of priority or payment by it of any money pursuant to this
Request or any authority mandate.
2. The Financial Institution may, in its absolute discretion, at any time by
notice in writing to me/us, terminate this Request as to future debits.
3. The User may, by prior arrangement and advice to me/us, vary the
amount or frequency of future debits.
4. By signing this Direct Debit Request you acknowledge having read
and understood the terms and conditions governing the debit
arrangements between you and the Media, Entertainment & Arts
Alliance as set out in this Request Service Agreement to be provided
upon commencement of Direct Debit.
Customer Signatures
Customer address
may be required
Postcode
SCHEDULE
Please debit my bank/credit union account for
membership fees:
Amex
Card number
weekly
fortnightly
monthly
quarterly
half-yearly
annually
Card name
$76,000 - $99,599
Student*
Year
Expiry date
Signature
Name of account
Date
I understand that MEAA will notify me in writing each financial year with
my deduction schedule.
BSB Number __ __ __ - __ __ __
Account Number
PLEASE NOTE: Direct debiting is not available on the full range of
accounts. If in doubt, please refer to your financial institution.