Become an Associate Member

ASSOCIATE MEMBER APPLICATION FORM

Application for membership of the Les Toques Blanches Victorian Chapter Inc in VIC Reg No A00 39465G.
Please complete the online application form below. Make sure all required fields are filled in before submitting your application.

Full Name

Occupation

Address

Address Line 1

City

State / Province / Region

Postal Code

Contact Number

Email

Nominated By

Name

Phone

Email

Checkboxes

By providing a nominator’s details, you authorise us to contact them for verification of your nomination.

Seconded by

Name

By are Number

Phone

Email

Checkboxes (copy)

By providing a nominator’s details, you authorise us to contact them for verification of your nomination.

WORK / COMPANY DETAILS

How are you applying for Associate Membership?

Individual Professional
Restaurant / Company Representative

WORK HISTORY OUTLINE

Place

Country

From

To

Upload Resume

Drag & Drop Files, Choose Files to Upload

Please upload your resume in .pdf format and max file upload is 10mb.

Kindly verify that all information provided is complete and accurate.
You will not be able to make further changes after moving to the final submission page.

Agreement

I desire to become an Associate Member of Les Toques Blanches Victorian Chapter Inc. in Victoria. In the event of my admission as a member, I agree to be bound by the rules of the Association for the time being in force.

Agreement (copy)

I agree to pay the membership fees within 28 days of invoice, if accepted at the next general meeting.

Joining Fee: $400
Annual Fee: $400

Date of Submission

Signature

Clear Signature

Nominated By

Seconded by

Company Information