Annual Associate Membership Registration Form...

1 July 2010 TO 30 June 2011
Please select from one of the full membership options Full membership please note: Based on a sales turnover for the year ended 30 June 2009. This applies to all fruit juices and mixers of fruit juices, fruit drinks and fruit cordials.		Membership Fee Total Payable (inc GST)
A.	Below $1M	$993
B.	$1M TO $5M	$1,663
C.	$5M TO $10M	$1,982
D.	$10M TO $15M	$2,600
E.	$15M TO $20M	$3,213
F.	$20M TO $30M	$4,552
G.	$30M upwards	$6,427
You will be contacted by an FJA representative who will provide you with payment details once your affiliate application has been approved.

Affiliate Contact Information Please fill out all applicable fields
Company Representative:		What Happens Next? Once you have submitted your application, you will be contacted by a staff member of the FJA, who will inform you of the application decision and organise the payment of the FJA membership fees if you are a successful applicant. Please allow 1-2 working days for the application to be processed.
Company:
Address:
Business telephone:
Business fax:
Mobile:
Business email:
How do you wish to be contacted?
Send us the Details:

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