Attention! If you are RENEWING your membership, please use the email that was sent to you and click on the link in the email which will take you to the Renewal Form. This form is for NEW membership signups only.

Apply Here for Healesvile CoRE Membership

Please select to renew one of the following 3 Membership Categories: Associate membership (14 years old and under), Individual membership, or Business membership (for Business membership, please check the box "I am contributing on behalf of an organisation").

Membership Type: *

Associate (14 years and under) - $ 0.00 (includes GST of $ 0.00)

Individual - $ 25.00 (includes GST of $ 2.27)

Business - $ 90.00 (includes GST of $ 8.18)

Total Amount

Email Address *

I am contributing on behalf of an organisation.

On Behalf Of Organization

Organization Name *

Phone (Main) *

Email (Main) *

Street Address *

City *

Postal Code *

Country *

State/Province *

Your Details

First Name *

Last Name *

Phone *

Street Address *

Street number and address only

Supplemental Address

Add additional address info here e.g. Unit 1, Building name etc

Suburb *

Post Code *

Back account details for direct deposit

Account Name: Healesville Community Renewable Energy Inc T/A Healesville CoRE

BSB: 633000 Account Number: 161834312 - OR - PayID: 98 988 563 885

Membership Application Form

Apply Here for Healesvile CoRE Membership

Please select to renew one of the following 3 Membership Categories: Associate membership (14 years old and under), Individual membership, or Business membership (for Business membership, please check the box "I am contributing on behalf of an organisation").

Membership Application Form