Test iFrame Embedded page Order Number About Your Organisation We need to know a few things about your organisation. Organisation Name * Street Address * Supplemental Address City * State * Select a State/TerritoryAustralian Capital TerritoryNorthern TerritoryNew South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Country * Select a CountryAustralia Postcode * Annual Membership Income Tier and Fee * Under $100,000 Income Tier - $ 50.00 $100,000 - $250,000 Income Tier - $ 810.00 $250,000 - $500,000 Income Tier - $ 1,300.00 $500,000 - $1m Income Tier - $ 2,175.00 $1m - $2m Income Tier - $ 3,480.00 $2m - $4m Income Tier - $ 4,885.00 $4m - $7m Income Tier - $ 6,795.00 $7m - $11m Income Tier - $ 8,700.00 $11m - $16m Income Tier - $ 9,780.00 $16m - $100m Income Tier - $ 13,050.00 Over $100m Income Tier - $ 17,400.00 For information on how the annual income of members is determined, see the ACOSS Membership Income Assessment Guidelines. Website Constitution, Rules or Charter * Please upload a copy of your organisation's constitution, rules or charter. PDF format required. Annual Report If available, please upload your organisation's most recent annual report. PDF format required. Purpose of Organisation * You may like to answer the following in your description: Does your organisation represent or engage in advocacy for a particular group of people? Does your organisation focus on service provision, advocacy or a combination of the two? What are the priority areas of work for your organisation over the next few years? Number of FTE Staff 1-5 6-20 21-50 51-100 101+ Organisation Type Peak body Community service organisation Consumer group Trade union Other Application Contact We need your contact details to update you on the progress of your organisation's application. First Name * Last Name * Position at Organisation * Email * Phone * Confirm Email *