Green Collect Membership
Membership Form
Name of organisation:
Address of organisation:
Date:
Number of floors occupied:
Number of employees located at above address:
Number of collection bins required:
Details of contact person:
Details of secondary contact person:
Name:
Name:
Phone:
Phone:
Email:
Email:
Fax:
Fax:
Please select from the following options (all are GST inclusive):

Corporate Membership – annual service fee $1,200

Additional Site – annual service fee $ 440 (Additional Form will need to be filled out)

Schools Membership – annual service fee $1,200

Small Business Membership – annual service fee $ 300

Community Group Membership – annual service fee $ 200

Additional Donation $_______________ (Donations to Green Collect are tax deductible)

Electronic Funds Transfer

Cheque payable to Green Collect
BSB: 633 000
Account: 124 098 971
Please note, a quarterly per kilogram service fee for units collected will be charged in addition to the annual
membership above.
PLEASE COMPLETE THIS FORM AND FAX TO 9650 7936, OR EMAIL TO
memberships@greencollect.org
If you would like to support the work of Green Collect, Donations above $2 are Tax Deductible
Level 7, 174 Collins Street Melbourne VIC 3000
Phone: 03 9663 8843
Fax: 03 9650 7936
Email: contactus@greencollect.org
www.greencollect.org
Green Collect Limited
ABN 68 112 489 684
Green Collect Membership
Membership Feedback
We would appreciate any feedback about your membership or improvements for your continued
membership. Please complete the attached form with your comments and return it to the address listed
below.
We would like to include your organisation logo on our member page. Please confirm your acceptance of
this below.
Organisation Name___________________________
High Importance
How highly does your company rate its
contribution to:
The job and income security of those finding
new employment with Green Collect
Reduction of waste to landfill
Developing a network of organisations
committed to improving the social and
environmental well being of our city.
Does your organisation publicly report on
environmental or sustainability
performance?
Which other services offered by Green
Collect would you be interested in
exploring?
□
□
□
□
□
□
Low Importance
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
Yes
No
Waste/Paper Assessment
Sustainable Purchasing Program
Green Office Services
Other , please specify
What other products would your
organisation like to see recycled?
Do you have further feedback for Green
Collect?
WEBSITE
□
□
Green Collect has permission to display our organisation logo on the Green Collect website
www.greencollect.org to indicate that our organisation is a Green Collect Member.
Green Collect has permission to display our organisation logo on Green Collect promotional material to
indicate that our organisation is a Green Collect Member.
Please tick your acceptance and sign here:
Name: ______________________________
________________________________
Signature
___________________________
Position
__________
Date
Please complete this form and fax to 9650 7936 or email relevant information to contactus@greencollect.org
If you would like to support the work of Green Collect, Donations above $2 are Tax Deductible
Level 7, 174 Collins Street Melbourne VIC 3000
Phone: 03 9663 8843
Fax: 03 9650 7936
Email: contactus@greencollect.org
www.greencollect.org
Green Collect Limited
ABN 68 112 489 684