Company
Mailing Address
Physical Address
Primary Contact
Appointed National Representative*
* A member company's Appointed National Representative will have the authority to act on
behalf of the member company in relation to any matter requiring an official member response
or vote, including the CICA Board elections and all business of the Annual General Meeting
for CICA National issues. This person will also be registered as the Appointed State
Representative in the state the physical address list above, unless CICA is advised
otherwise. All correspondence in relation to membership will be directed to this person.
Additional Contacts
Additional contacts will receive notification of member meetings, CICA newsletters, Bulletins, Conference News, etc. in state of head office location. For other states please complete additional state offices section.
Authorisation
The above named Appointed National Representatives are authorised to act on the company’s behalf on any matter in relation to our CICA national and state branches. In submitting this form, the applicant agrees to comply with the CICA Constitution and the CICA Member Code of Conduct.
Additional State Offices / Branches / Distributors
All additional offices / branches / distributors will be included in the CICA website member listing and member email communications.
Please mark where indicated to advise if these Branch contact people are to be regarded as the State Appointed Representative for CICA State Branches in their state:
- Where a tick is indicated below to nominate the state person they will be eligible to vote on any state issues instead of the National Appointed Representative.
- Where no instruction is given to CICA, authority to vote on state issues will remain with the National Appointed Representative. This procedure has been put in place to protect the “One Member / One Vote” principle.
Business Referee - Must Be An Existing CICA Member
Reason For Applying For CICA Membership
Application Process
Membership Applications must be accompanied by full payment.
Applications for membership are subject to approval by the CICA Board of Directors usually at their next meeting, so this process may take up to 2-3 months.
Membership is for the period 1st July to 30th June each year (Prorata fees may apply. Please contact the CICA office for assistance).
Receipt of Membership Applications will be acknowledged by the CICA Office via email.
Member discounts are available whilst waiting for Board approval.
Once Board approval is received formal advice and a Member Welcome Pack will be forwarded by mail.
