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Institution Name *(in English) 
Institution Name(in your language) 
Institution Address* 
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Name and position of person to whom correspondence should be addressed:
Contact Name
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Membership Details

Membership Category
A(budget < $55k)   $500.00
B(budget $55k-$200k)   $600.00
C(budget $200k-$2m)   $900.00
D(budget $2m-$20m)   $1200.00
E(budget > $20m)   $2500.00
 
PLEASE NOTE: Membership is annual and runs from January 1 to December 31 of the year in which subscriptions are paid. New memberships received after September 30 will become effective as from January 1 of the following year unless otherwise indicated
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Please tick the categories that apply to your institution:
A: CATEGORY OF INSTITUTION
Botanical Garden Museum
Conservation Institute Natural Park / Animal Reserve
Cultural Centre Research / Training Institute
Exhibition Gallery Zoological Garden / Aquarium
Library/Archives OTHER: Please Specify  
B: GOVERNING STATUS
Association Private
Country Provincial
Foundation / Society Regional
Municipal University
National OTHER: Please Specify  
C: TYPE OF COLLECTION
Agriculture / Rural Heritage Maritime
Applied Arts Medicine
Archaeology Military History
Architecture Modern & Contemporary Art
Children's Museum Money & Banking
Costume Musical Instruments
Decorative Arts Natural History
Eco museum Open air
Education Performing Arts
Ethnology / Ethnography Photography
Fine Arts Regional/Local
Historic House Science & Technology
History Sculpture
Industrial Heritage Sports
Literature Transport & Communications
Other: Please Specify  
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ICOM Australia sets out in its Privacy Statement how it collects, uses and discloses members' personal information. This statement is framed by the Privacy Act 1988 (Cth) and as amended. The Privacy Statement can be found at: www.icom.org.au/policiesprivacy.php

Information you provide on this form will be transmitted to third parties: ICOM headquarters and ICOM’s International Committees. You have the right to access and to modify your information. The French law on Informatics & Civil Liberties (Jan. 6, 1978, rev.) provides for the equivalent right. nt right

 
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Please read ICOM Australia's conditions of purchase and bookings information.

 * I declare that my institution is eligible for membership of the International Council of Museums (ICOM) and wishes to become a member of ICOM. My institution does not engage in dealing (ie. buying and selling for profit) in the field of cultural property and accepts the ICOM Code of Ethics for Museums.