Page 19 - VACC Membership Kit 2023

Contract Request Form
Member Details
Trading name
Legal entity name
Address
Contract type
Contact person
Email
Total number of employees
ACN
VACC member number Phone
Does the business have related entities? Yes No
Payment Details
EFT Visa MasterCard
Card number
Name on card Cardholder signature
EFT payment details: Westpac | BSB: 033079 | Account No: 000273
Total $
incl of gst
Please clearly state Company name and Contact as the payment reference.
Acc No. 5672-40 ABN 63 009 478 209 This document becomes a Tax Invoice for GST when fully completed and you make your payment.
Exp /
CCV
Employee Details
Employee’s name
Employee’s address
Suburb Postcode
Employment Details
a) New employee b) Confirmation of employment Age (only if a junior position)
VISA Details
Is your employee on a work VISA? No Yes Type of visa
If your employee holds a visa you must provide a copy of the employee’s passport (photo ID page only) and a copy of other immigration related documents (if applicable) with this request form. Copies of official qualiificaation documents (trades recognition assessments) should also be provided if applicable with this request form.
Type of employment full time part time casual
Commencement date / / Job title
Who will employee report to: Name
Title
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