Welcome to the Australian Intranets Affiliate Program. Please complete our online application form below, using both upper and lower case (e.g. John Citizen - not john citizen). All information is required to be completed, unless indicated as optional. Upon receipt of your application, we will assess it before contacting you.
Contact Information
Company/Organisation Name:
Web Site Name:
Web Site URL:
Contact's Name:
Contact's Phone:
Contact's Fax:
(optional)
Contact's Email:
Address Line 1:
Address Line 2:
City/ Suburb:
State/ Territory:
Post Code:
Country:
Your Australian Intranets address:
www. .intranets.com (optional)
Accounting/ Billing Information
Australian Business Number (ABN):
Are you registered for GST?
(Goods & Services Tax):
Yes No
Company Type:
Classification:
Accounting Contact Info:
check here if same as primary contact info
Accounting Contact's Name:
(optional)
Accounting Contact's Phone:
(optional)
Accounting Contact's Email:
(optional)
Submission Information
Thank you for your interest in becoming an affiliate of Australian Intranets and for completing this application.
Before submitting your application for approval, you MUST tick both check boxes below to confirm that:
Yes, I have read and understood the Affiliate Program Agreement
and agree to be bound by those terms and conditions.
Yes, I am the owner (or am authorised to act on behalf of the owner) of the web site I have specified.
