First Name

Last Name

Email

Username

Password (8 or more characters, inc. upper case, lower case and number)

Confirm password

Phone

Address

Address2

City/Town

State

Post Code

Country

URL

Company

Membership Type

Individual Member - $50.00

Individual Member ~ Concession - $25.00

Business/Organisation Member - $125.00

Payment Method

Credit Card (Stripe)

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AEVA Membership Form

Section 1. Member Information

Section 2. Membership Type

Section 3. Payment Method

Section 4. Groups to join (for email updates)

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