ANA Membership Application form Thank you for your interest in joining the Australian Nappy Association! Please see this page to learn what the different membership levels mean. Step 1 of 2 50% Name* First Last Date of birth* DD slash MM slash YYYY Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneType of membership* Friend of the ANA $20 Supporter membership $150/year Industry membership $450/year Are you applying on behalf of a business?* Yes No Business or organisation name* Logo*Please upload a logo file. Minimum 800x800 in JPG/JPEG format.Accepted file types: jpg, jpeg, png, gif.Main email for correspondence* Website* ABN / ACN* Are you registered for GST?*If your business is not registered for GST, then we assume you're earning under $75,000 a year. Your membership is half price! Yes No Year business began operation*2020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990Before 1990Insurance policy details*Please upload a copy of your insurance policy. If you own/operate a business you MUST provide evidence of Insurance. Drop files here or Select files Max. file size: 256 MB, Max. files: 5. What areas does your business cover?*Select all that apply. Manufacture Online retail Market retail Nappy library Wholesale Storefront retail Expo retail Laundry service What type of organisation?* Consumer Midwife / LC / CHN Online community Government I am interested in growing cloth nappy use through:Choose as many as apply. Public advocacy Affiliated professionals Articles & links Government initiatives Media & events Branding FAQ fliers Collective advertising Expo presentations Research Project grants Accreditation program What unique skills do you have that might be helpful to the ANA? e.g. graphic design, event planning, public relations, or anything else.I declare the information provided by me is true. I agree to abide by the Constitution and uphold the values of the Association.*Click here to read the ANA constitution I agree Industry membership Price: Supporter membership Price: Friend of the ANA Price: Do you want to pay in installments?*Industry members can pay half on joining and half later.I'll pay in full now.I'll pay half now and half later.Industry membership: Small turnover discountYou're not registered for GST, so your membership is half price! Price: $ 0.00 Supporter membership: Small turnover discountYou're not registered for GST, so your membership is half price! Price: $ 0.00 Installment amount Price: Do you have a coupon code? Enter it here. Total $ 0.00 Subscribe to the industry newsletter? Yes Subscribe to the Cloth Matters newsletter? Yes EmailThis field is for validation purposes and should be left unchanged.