□ WNA Member (please supply their name so we can send them a gift of
appreciation for your referral).
________________________________________________________
□ Radio, television or newspaper article
□ Government Agency
□ WNA weekly eNoticeboard
□ Website _______________________________
□ Working Women Magazine
□ Heard about WNA at an event
□ Social and online media:
□ Referred by my business coach/mentor
□ Search Engine
□ Facebook
□ Twitter
□ LinkedIn
□ Other_________________________________
Personal details
Title:
□ Ms
□ Mrs
Name:
□ Miss
□ Mr
□ Dr
□ Prof
Surname:
Home address*:
Suburb:
State:
P/code:
*Privacy disclaimer: This information is for WNA purposes only and will not be provided to any other organisation or person without the express permission of the member.
Business details
Company/Business name:
Position held:
Postal address:
Suburb:
State:
P/code:
Suburb:
State:
P/code:
Business Ph:
Fax:
Mobile:
Home:
Delivery/courier address:
Email Address:
Web: www.
VOIP address:
Skype Account:
Membership Options: Please select one from the following two membership options
□ Option 1
Individual Membership
Initial joining fee:
(payable once only)
Initial joining fee:
(payable once only)
$249
Annual membership fee:
$170
TOTAL
□ Option 2
Corporate Membership
(Up to 10 members from the same company)
$ 419
$400
Annual membership fee:
(Indicate total number of
Members joining.)
$170.00 x ______ members $______
TOTAL
$______
www.womensnetwork.com.au
How did you hear about us?
Please select your Business Category (tick one only):
NB: Please base your decision on the activity undertaken by the business you own or work for rather than
your position in the business when selecting a business category from the list below. E.g. a marketing
manager working for a law firm would select 'solicitors' and not 'marketing consultants'.
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Academia
Accountants
Advertising Agencies
Aged Care Services
Agriculture
Animal Care Services
Architects and Town Planners
Aromatherapy Products & Services
Art Galleries
Artists
Auction Services
Audio Visual Services
Author
Automotive
Banking and Finance
Beauty Clinics
Beauty Services
Boat and Marine Services
Bookkeeping
Building and Construction
Business Brokers
Business Services
Business/Life Coaching
Carbon Neutral Services
Career Consultants
Carpet and Flooring
Charities
Child Care and Training
Chiropractor
Cleaning | Commercial and Domestic
Clerical Services
Coffee Shops
Community Services
Computer and Technology
Conference/Training Facilities
Cosmetic Procedures
Cosmetics
Counselling Services
Couriers
Crafts and Hobbies
Dance Studios
Day Spas
Debt Collection Services
Dentists
Dietitians
Dry-Cleaners
Editing and Writing Services
Education | Adults
Education | Children
Emergency Services
Energy Suppliers
Engineering Consultants
Event Co-ordination
Executive Coaching
Fair Trade & Ethical Products
Fashion
Fashion Designers
Training | Communication
Training | Computer
Training | Corporate
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Fashion | Babies and Children
Fashion | Bags and Luggage
Fashion | Formal Wear
Fashion | Lingerie and Sleepwear
Fashion | Shoes and Accessories
Feng Shui Consultants
Financial Planners
Fitness
Florists
Food and Catering
Fundraising
Funeral Services
Gardening and Landscaping
Gift and Hamper Services
Glass and Glazing Services
Government/Public Service
Graphic Designers
Gynaecology | Fertility Clinics
Hairdressers
Handyman Services
Health Care
Health Clinics | Medical Centres
Home Improvement
Homeopathy
Hospitals
Hotels and Accommodation
HR Services
Hypnotherapists
Image Consultants
Import and Export Services
Insurance Agents/Brokers
Interior Design & Décor
Internet Services
Introduction Agencies & Services
Investment/Education
Jewellery
Legal Services
Library and Information Resources
Lifestyle Services
Manufacturing
Marketing Consultants
Massage Therapists
Media/Journalist
Mentoring Services
Migration Services
Mining and Resources
MLM Independent Distributors
Mobile Technology
Mortgage Brokers
Multimedia Services
Natural Therapists
Naturopaths
Network Marketers
NLP Practitioners
Non-Profit Organisations
Nutritionists
Office Equipment
Travel Services
Training | NLP
Training | OHS
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Online Business Resources
Online Entertainment
Online Marketing Consultants
Online Marketing Services
Online Social Networks
Optometrists
Organisational Services and Products
Osteopaths
Parenting/Children Services
Party Planning
Personal Care Products
Personal Concierge
Personal Organisers
Personal Trainers
Pets Care and Services
Photographers
Physiotherapists
Pilates Instructors
Podiatrists
PR Consultants
Printers
Professional Associations
Promotional Products
Property Developers
Property Investors
Psychologists
Publications and Books
Publishing Services
Real Estate Agents
Real Estate Services | Property
management
Recruitment Services
Relocation Services
Restaurants and Cafés
Resume Services
Retailers | Online
Retailers | Party Plan
Retailers | Store
Security Services
Serviced Offices
Skin and Body Products
Software Application Services
Solar Energy Services
Solicitors
Speakers and Entertainers
Speakers Bureau
Sport
Stationery Suppliers
Stock Brokers
Swimming Pool Services
TeenPreneurs
Telecommunications
Telemarketing Services
Tourism Facilities
Training | Aviation
Training | Business Administration
Training | Certified
Web Services and Hosting
Website Designers
Wedding Services
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Training | Directors
Training | Employment
Training | Health Care
Training | Management
Training | Metaphysical
Transitional
Transport and Freight
Training | Public Speaking
Training | Sales
Training | SME and Franchising
Training | Technology Vehicle Hire
Service
 Virtual Assistants
 Warehousing/Logistics
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Weightloss Services
Wholesalers
WNA Group Affiliates
Workplace Health and Safety
Yoga Classes and Services
Provide a brief description of your job or business:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
On receipt of your application you will be subscribed to our electronic mailing list. Please indicate your preference in regards
to the electronic information you wish to receive from WNA (multiple selections can be made):
Electronic Invitations:
NSW
VIC
QLD
WA
□ Sydney □ Albury/Wodonga □ Brisbane □ Perth
□ Melbourne
□ Cairns
□ Gold Coast
□ Sunshine Coast
□ Redlands
ACT
TAS
□ Canberra
□Hobart
□ Launceston
Electronic Alerts:
□ OnlineVINE This Member service provides alerts for speaking opportunities, media calls, cross-promotional opportunities and
board vacancies.
Payment details: Please find attached my cheque payable to Women's Network Australia Pty Ltd or
Card Type:
□ Visa
□ Mastercard
□ American Express
Card Number:
 /  /  / 
Expiry: (mm/yy) _______ / _______ CCV: __________
Cardholders Name: ____________________________________________________________________________
Signature: _____________________________________________________Total amount: $__________________
Women’s Network Australia Pty Ltd - HEAD OFFICE | PO Box 1723, Sunnybank Hills QLD 4109
T: 1800 052 476 F: (07) 3272 8111
E: wna@womensnetwork.com.au
W: www.womensnetwork.com.au
Women's Network Australia Pty Ltd ABN 66 010 793 727