Renewal of individual membership

Regular and Retired Individual ICOM members are invited to renew their 2015 membership. Membership is annual from 1 January – 31 December.Renewals should be made as soon as possible. Memberships ‘lapse’ if not renewed by 30 March 2015.
Former members may renew without penalty, but must advise of any changes in professional status or contact details.

All renewing members must certify that they are not dealing in cultural property.

The information requested below is required by the International Council of Museums (based in Paris). Please provide as much information as possible even if you have previously supplied your details.

Current members may renew via:

  • online by credit card or direct bank deposit at
  • by cheque or money order, made payable to ICOM Australia, along with this form
  • by credit card (Visa or MasterCard only), along with this form

ICOM Australia Membership Number

Title First Name/s Last Name

Email address

Mailing address

City StatePostcode Country

Contact Phone Number Date of BirthGender Language

Institution (or former institution)

Position Title

Institution address (if different from mailing address)

City StatePostcode Country

Phone Number Institution Website

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Are you a current member of Museums Australia? (MA Individual Members receive a 5% discount on ICOM Membership)

MA Member Number

Preferred contact method?

Membership Payment(fees are in Australian Dollars and are not subject to GST)

Payment method:

BSB: 062-900 (Commonwealth Bank of Australia)

Account Number: 10216161

Name: Museums Australia

Reference: Your member number and name

Add $3.00 credit card surcharge

Card Number: Expiry Date: /

Name on Card:

Total Payable $

Membership period

Membership is annual from 1 January – 31 December.

Privacy

ICOM Australia sets out in its Privacy Statement how it collects, uses and discloses members' personal information. This statement is framed by the Privacy Act 1988 (Cth) and as amended. The Privacy Statement can be found at:

Information you provide on this form will be transmitted to third parties: ICOM headquarters and ICOM’s International Committees. You have the right to access and to modify your information. The French law on Informatics & Civil Liberties (Jan. 6, 1978, rev.) provides for the equivalent right.

Authorisations

I authorise ICOM including ICOM Australia to publish my information on their websites (access to this information is restricted to ICOM Australia officers, ICOM Paris officers, ICOM committees, ICOM affiliated organisations & member services providers)

I authorise ICOM including ICOM Australia to transmit my information to non-ICOM third parties (such as conference organisers, Museums Australia, printers, mail distributors etc)

Declaration

I, , hereby declare that I remain eligible for membership and I formally accept and respect the ICOM Code of Ethics for Museums ( I am not engaged in dealing (i.e. buying and selling for profit) cultural goods including works of art or natural and scientific specimens.

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