I certify that I meet the eligibility requirements for Membership of First Nations Media Australia outlined here. In applying for membership of First Nations Media Australia, I declare that I agree with the Objects of First Nations Media Australia and that its representatives will abide by the membership policies set out on the First Nations Media Australia website at https://firstnationsmedia.org.au/about/membership. I understand that: * This form must be completed by someone with authority to sign documents on behalf of an organisation, or an individual. Completing your name and date on this form will constitute as a digital signature for the purposes of membership application/renewal. * That the First Nations Media Australia Board holds the final decision regarding membership approval, eligibility and renewal. By ticketing this box you agree to the above * Yes, I agree Membership Information Please review and select the type of membership you would like to renew or apply for. Reminder: this form is for organisational memberships. If you would like to sign up or renew an individual, click here. Ordinary membership (voting membership) A Remote Indigenous Media Organisation (RIMO) An Aboriginal and Torres Strait Islander not-for-profit broadcasting licensee (for example Remote Indigenous Broadcasting Service, remote, regional and urban not-for-profit radio station) An Aboriginal and Torres Strait Islander not-for-profit media production organisation with media production as a core constitutional objective Associate membership An Aboriginal and Torres Strait Islander not-for-profit organisation: Producing media, but without media production as a core constitutional objective Affiliate membership A non-Indigenous not-for-profit organisation engaged directly with Aboriginal and Torres Strait Islander broadcasting and media. Friend of First Nations Media Australia membership An organisation not eligible for Ordinary, Associate or Affiliate membership and supporting the goals of the not-for-profit Aboriginal and Torres Strait Islander broadcasting and media sector. Select type of membership you would like to apply for * - Select -Organisational - Ordinary (voting membership, $275 inc GST)Organisation - Associate ($165 inc GST)Organisational - Affiliate ($27.50 inc GST)Organisational - Friend of First Nations Media ($27.50 inc GST) Please explain how your work aligns with one or more of the following areas * Support the preservation and maintenance of Aboriginal and Torres Islander cultures and languages. Advocate on behalf of Aboriginal and Torres Strait Islander peoples in relation to their needs and interests in media and communications, including supporting strong employment, education and health outcomes. Use media and communications to enhance opportunities for self and community advancement. Promote the inclusion of Aboriginal and Torres Strait Islander peoples in the digital economy, through access to appropriate communications technologies and services. Support the production of media tools, content, programming and services in Aboriginal and Torres Strait Islander communities that leads to improved enjoyment of life and betterment of circumstances. Facilitate greater respect for and recognition of Aboriginal and Torres Strait Islander cultures and traditions within the broader Australian community, through the promotion of the activities, organisations, media products and people working within the Aboriginal and Torres Strait media sector. Promote media and communications as an essential service to remote Aboriginal and Torres Strait Islander communities. (Max 500 words). ORGANISATION DETAILS Organisation Name * Legal Name * Legal Status of Organisation * - Select -ORIC RegisteredCompany limited by guarantee (ASIC registered)Propriety Limited Company Limited by Shares (ASIC Registered)Association or cooperative registered under State or Territory legislationGovernment bodyPublic broadcasterOther not-for-profitBusiness or other for-profit organisation ABN * Email (This is where renewal notifications will be sent) * Phone Number * Street Address * City * Postal Code * State/Province * Please provide a brief description of your organisation’s relationship to the Aboriginal and Torres Strait Islander broadcasting and media sector * Membership - Organisation Fields Main Contact First Name * Main Contact Last Name * Main Contact Job Title * Main Contact Email * Main Contact Phone Number * If this is a different address to the organisational address please complete the fields below. Main Contact Address Main Contact State - Select -Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Main Contact Postal Code NOMINATED REPRESENTATIVE DETAILS Aboriginal and Torres Strait Islander Associate Membership Representative (non-voting)* The person is to be an Aboriginal and Torres Strait Islander person aged 18 years and over and otherwise eligible for Associate Membership of First Nations Media Australia. This person is the primary person engaging in First Nations Media Australia General Meetings, and may the same person as the primary contact. If so please note "same as primary contact person". Each Ordinary Member is to nominate a person to represent and exercise the voting rights of their organisation at First Nations Media Australia General Meetings. The nominated person is to be an Aboriginal and Torres Strait Islander person aged 18 years or over, currently active in the Aboriginal and Torres Strait Islander broadcasting and media industry. Nominated Representative First Name * Nominated Representative Last Name * Position Held by Nominated Representative * Nominated Representative Email Address * Nominated Representative Phone Number * If this is a different address to the organisational address please complete the fields below. Nominated Representative Mailing Address Nominated Representative State - Select -Australian Capital TerritoryNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Nominated Representative Postal Code Signature Signer Name * Next Page >
