Membership Application Form

Membership Rules

View/Download Association Rules

Apply Here for Healesvile CoRE Membership

Please select 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 *

Please be sure to click on the 'Review your contribution' button above to complete your membership application. Please click the button one time only.

Bank 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

Please use your full name as the reference.