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PRIMARY MEMBER INFO

UPLOAD SIGNATURE OR PRINT NAME

Your signature above serves notice that you have verified that the information provided on this form is accurate. It also serves as a consent by you and any additional members to receive communication from the AIS community by mail, phone, fax, and email including communications promoting conferences, general meetings, products and services.
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Primary reason for joining AIS
How did you hear about AIS?
Are you currently a member of any other buying group?
Previously been a member of any other buying group?
List all individuals, companies or shareholders that have a vested interest in the business entity listed above.
That is all beneficial owners in whole or in part of the Applicant Business.
Names of Individuals, Companies or Shareholders
Address
Nominated Representative
Person nominated by the Applicant Business being the Sole Trader, a Partner, Director or Senior Manager authorised to manage the rights and responsibilities of a shareholding of Australian Industrial Supplies Ltd on behalf of the Applicant Business.
Phone, Fax and Email are to be applicant business details.
MEMBERSHIP DEMOGRAPHICS
AIS is committed to providing members with a sustainable and growth platform to support their existing business. In order to best understand the opportunities please list your previous 3 year sales turnover.
Retail Sales Turnover
Annual Retail Turnover
Annual Total Business Turnover
Total Business Turnover includes other areas of the business which are not related to retail product sales
Main Retail Product Categories