2017 ATOM NSW Membership form
ABN 32 692 429 943 (not registered for GST)
Membership period: 1 January – 31 December
Membership categories (please choose one)
*For institutional membership up to 4 teachers covered.
Personal Membership $80.00
Institutional Membership* $180.00
Student Teacher/Beginning Teacher Membership $60.00
Suburb, State, Postcode
Areas of Interest/ Expertise
Interest in providing professional learning opportunities:
For Institutional membership please submit the names and email addresses of those who will be covered (Max 4 teachers)
Payment options: (ATOM is not registered for GST)
Cheque: Please make cheque payable to: Australian Teachers of Media NSW Inc
Direct Debit: BSB: 062498 Acct No: 10497761 (Quote Membership 2017 and your ‘Name/ School Name’)(Please remit to us a copy of the EFT confirmation. We will not be able to process your membership without this)
Total amount payable
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