Membership Application

Members Benefits

STA WA Membership Application Form Payment

First Name

Last Name

If this application requires additional names to be added then please check the box.

I require additional names

First Name

Last Name

First Name

Last Name

First Name

Last Name

ORGANISATION

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone/Mobile

Purchase Order No:

Please process this application and send a tax invoice

Membership Fees

Student - $59.00

Individual - $100

Corporate - $275

Group of 4 - $350

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Pay with Card (Stripe)