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Membership Application Form
Membership Application Form
Applying for membership of BioMelbourne Network
Membership of BioMelbourne Network covers all employees in your organisation. Once your membership application has been submitted and approved by the BioMelbourne Network Board, we will contact you for payment and information that will enable us to promote your organisation on our website.
Organisation details
Organisation name
*
Address
*
Industry
*
Biotech & Pharmaceuticals
MedTech & Digital
Life Sciences Related Sectors
Academic Research Organisations
Hospital & Healthcare
R&D Service Provider
Sector Support Service
Government or Not-For-Profit
Other
Membership type
*
Corporate Membership
SME Membership
SME-Micro Membership
Professional Membership
Entrepreneur Membership
View membership types and rates here: biomelbourne.org/become-a-member
Is this company ASX listed?
Yes
No
Company website (URL)
Company social media accounts
e.g. LinkedIn, Twitter
Further details to support application
These answers give our Board a better understanding of who you are and where your interests lie.
Provide a short description of your business, and how this relates to BioMelbourne Network.
*
What are your primary reasons for joining BioMelbourne Network?
*
What would you like to get out of your BioMelbourne Network membership?
*
Senior primary contact details
Please enter the details of an executive level contact to receive key member communications.
Title
First Name
*
Last Name
*
Position
*
Mobile Number
*
Other Contact Number
Email
*
Secondary contact details (optional)
You can choose to enter the details of a secondary person that will appear on our website as your organisation’s public facing contact.
Title
First Name
Last Name
Position
Mobile Number
Other Contact Number
Email
Declaration
By submitting this form you are confirming that you wish to become a member of BioMelbourne Network Incorporated and you agree to be bound by BioMelbourne Network Rules of Incorporated Association for the time being in force. Access the BioMelbourne Network Rules of Incorporated Association here: https://biomelbourne.org/wp-content/uploads/2020/11/BMN-Rules-of-Incorporation-Victoria-2014.pdf
Date
If you are human, leave this field blank.
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About
About Us
Contact
Our Board
Life Members
Our Team
History
Membership
Member Directory
Network Engagement Benefits
Become a Member
Wilam
BioResource Hub
Events
Upcoming Events
Previous Events
Sector Events
Initiatives
Three-Year Strategy
Insider Report
Data and Insights, Identifying Opportunities and Advocacy
Healthtech Industry Development
Sector Promotion
Women in Leadership Awards
Trade Mission with Singapore 2022
Global Victoria – Healthtech Talks Podcasts
BioMelbourne Network Podcast
Industry Insights
News
Grants & Funding
Jobs
Advocacy