Membership Application Form – Charitable Reuse Australia

Membership Application

Organisation Name*

Nominated Representative*

Position*

Address*

Street Address Address Line 2 City State Postcode

Email*

Phone*

Company Website

Membership Category

Please tick the membership category appropriate to your organisation.*

National – Annual Membership $11,300 pa plus GST

State – Annual Membership $2,530 pa plus GST

Regional – Annual Membership $2,025 pa plus GST

Local – Annual Membership $620 pa plus GST

National – Governance structure of a central constituent body exercising control of national recycling operations. Voting rights of three votes per state or territory.

State – Statewide governance structure and operations throughout the state. Voting rights of three votes in the state or territory represented.

Regional – Charitable recyclers who have regional operations or 2-8 retail sites. Voting rights of two votes in the state or territory represented.

Local – Charitable recyclers with local operations or one retail site. Voting rights of one vote in the state or territory represented.

Declaration of Eligibility

Membership of Charitable Reuse Australia is only available to eligible charitable reuse organisations. Please tick each statement below on behalf of the organisation.

Consent*

is a not-for-profit registered with the ACNC*

Consent*

has obtained Deductible Gift Recipient (DGR) Status from the ATO*

Consent*

has status as a charitable fund, charitable institution, public benevolent institution, health promotion charity or public benevolent institution employer*

Consent*

has paid employees and/or volunteers that are directly involved in the operation of reuse programs including collection, sorting, retailing, exporting of donated items, or providing clothing and goods to the public for charitable purposes*

Consent*

directly runs reuse programs exclusively to support the charitable purpose of the organisation*

Consent*

has been actively involved in the consistent operation of a reuse program for a minimum of 12 months*

Consent*

does not sell or otherwise allow the charity brand name to be used by a commercial operator to solicit donated goods*

Does your organisation have ACNC registration?*

Yes

No

If yes, please insert URL link from ACNC Charity Register

Does your organisation have DGR status?*

Yes

No

Authorised Signature

By filling out the fields below you are signing on behalf of the organisation.

Name (First and Last)*

Title*

Organisation*

Dated*

Phone

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