Apply for Membership

Please remember that ACREM is primarily a home based monitoring group. While other activities may be undertaken at times, these are not our main function or interest. Those interested in home based monitoring of CB emergency channels should join as a Monitor, whilst those who simply wish to support ACREM in a non-operational role should choose Associate membership.

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(click in field and use calendar, or enter date as "dd/mm/yyyy")




Residential Address

Postal Address (leave blank if same as above)




Contacts

This should be a home land-line number if one exists (as mobile phones can go flat), including area code. If there is no land-line in the premises then provide the primary mobile number you will use.

Only if different than above number. If you provided a mobile number as your primary contact and there is an alternate mobile number you can use in an emergency, then please list that.




References

Please provide the name and telephone number of two (2) personal references that have known you for a period of not less than 12 months. They may not be close relatives - i.e. must NOT be spouse/partner (including defacto), parent (including step), sibling (including step), son/daughter (including step), uncle/aunt/nephew/niece, or 1st cousin.





History

NOTE! Answering YES to the following does NOT automatically preclude you from membership. We take each application on a case-by-case basis and our Membership Team will discuss this further with you in the strictest confidence. However, providing false information is grounds for refusal of membership or instant dismissal, so please be honest in your answer.

Other than a minor traffic offence, have you been convicted (i.e. found guilty) of any criminal offence, either in Australia or elsewhere:

  1. where a bond or fine has been imposed, or no conviction recorded, or a period of community service ordered - within the last 5 years; or
  2. where any term of imprisonment has been imposed, including any term of periodic detention or suspended sentence - within the last 10 years

NoYes




Monitor Applicants

YesNo

YesNo




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