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Apply and pay for Club and Associate membership

For Club and Associate Members

How to join

It’s quick and easy to join COTA NT as a Club and Associate Member online.
Fill in the form below and pay online with a credit card*. It’s safe and secure.

On receipt of payment, a receipt will be sent automatically to your email address. A transaction fee of 1.75% of the total payment plus $0.30 is payable for credit/debit card payments.
Staff will be in touch with you for content (logo, website link, image and text) for your Club and Associate page.

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Organisation's Full Name*

Type of Organisation

Category*

Contact Person / Representative's Details*

First Last

Address (Full postal address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Best Contact Phone

Email*

Website

Payment and Membership Details

Membership Tiers*

$30 + GST - Organisations with gross income less than $25,000 p.a.

$75 + GST - Organisations with gross income less than $50,000 p.a.

$120 + GST - Organisations with gross income $51,000 - $300,000 p.a.

$250 + GST - Organisations with gross income $301,000 p.a. - $500,000 p.a.

$400 + GST - Organisations with gross income over $500,000 p.a.

GST (10%)

Price: $ 0.00

Transaction Fee

Price: $ 0.00

Total

Credit Card Details

Credit Card*

Card Details

Cardholder Name

On receipt of your application and payment, your request will be reviewed by COTA NT. We reserve the right to decline your application and return your payment. If your application is approved, you will be contacted by our staff.