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2015 New Member Application
I,
Print Full Name
Address:
Suburb:
Phone:
State:
Bus/H:
P/Code:
Mob:
Email:
Membership Referral – How did you find out about the Association? __________________________________
I hereby apply to become a Member of Funeral Celebrants Australia Association Inc. I have read and agree to be
bound by the Association’s Rules, its Code of Practice, Professional Development Program (full membership
category only) & other procedures as released. I agree to allow my website profile to be edited if required and to be
included on FCAA Celebrant Directories and Listings. **
Signed
Date:
MEMBERSHIP CATEGORY – Please select
2015
Full Membership Celebrant - open to any Celebrant in Australia who accepts and agrees $125
with the statements above ** and has satisfied the procedure for membership specified.
Associate Membership
- open to individuals, or a single-entity business associated
with the funeral industry including funeral directors. No voting rights or celebrant listing.
Corporate Membership
- open to businesses associated with the funeral industry
including funeral directors. Corporate members do not have voting rights.
NAME BADGE - optional
$
Member year is 1 Jan to 31 Dec
$100
$150
If you wish to buy a name badge, select below (Note badges are ordered periodically)
This is the default badge colour if NOT specified - $13
Metallic Bronze colour - $13
Name for badge (name only will appear):

PAYMENT please tick your option
Cheque
payable to Funeral Celebrants Association Australia Inc
EFTPOS
BSB 062 256 Acct 1045 2722 - include name & email receipt to FCCA ++
Cash
can be paid at Association Forums (Sydney only)
FULL AMOUNT PAID: $
WEBSITE LISTING: Please email up to 200 words with a recent JPG photo to funeralcelebrants@gmail.com
Name:
Area (eg Sydney metro)
Phone:
Mobile:
Email
Website:
Email up to 200 words and recent jpeg photo
Email form and payment receipt ++ to funeralcelebrants@gmail.com
Version 1/11/2014