Thank you for your interest in joining the AIBC. Please complete the registration form below.
Title * Select your title Dr Prof Mr Mrs Miss Ms
Name * Your name
Surname * Your surname
Email * Your email
Phone Your contact number (10 digits with no spaces)
Mobile * Your contact number (10 digits with no spaces)
Company Enter Company Name
Industry Network group(s) HealthcareFood & AgricultureMinerals, Energy & IndustryInvestment, Finance & InfrastructureEducation, Skill & TrainingOther (Please press ctrl+click to select multiple Industry options) If other, please specify
Job Title Enter your designation.
Website Enter website url.
Membership Type * Select Membership Type SME/Individual ($396) (GST inclusive)Corporate ($1375) (GST inclusive)National Corporate ($2860) (GST inclusive)
Discount Code Discount code
Address * Your business address
Suburb * Your suburb
State * Select state VIC NSW QLD ACT NT WA SA TAS OTHER
Postcode * Your postcode
Password * Your password Password Strength:
Confirm Password * Confirm password
Verify User *
Fields marked * are required.
