Insurance: Application Form

* Indicates the required fields

Australian Mens Shed Association

Incorporation No INC9886884

Insurance Membership Application

IMPORTANT NOTICE

Incorporation or ABN Number: (must be incorporated or have an ABN or under the auspice of an incorporated body to be eligible for AMSA insurance)

Name of Shed *

 

Shed Address

Name of person authorised to make application *

 

Contact Phone *

 

Contact Email *

 

Date of Application

Shed Activities *

 

Number of Members *

 

Are you Incorporated?

Incorporation Number