Online Membership Application. Name* Given Name Surname Company: if Corporate ApplIcationDate* Date Format: MM slash DD slash YYYY Address* Street Address City Suburb State Territory Post Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Email* Phone/MobileMembership*Enter Membership Option and how you will pay your membership. Annual Recurring available for all memberships. $50.00 Per Year Jan~Dec Annual Recurring Subscription $50 or other. Pay Via Credit Card or PayPal (Via our PayPay Page) $300.00 Life Membership (Over 60) $150 Corporate Membership $100.00 Family (2 Parents or Grandparents + 1 Child) $60.00 Family (1 Parents or Grandparent + 1 Child) $110.00 Family (2 Parents or Grandparents + 2 Children) $70.00 Family (1 Parents or Grandparent + 2 Children) $120.00 Family (2+ Parents or Grandparents + 3+ Children) $80.00 Family (1 Parent or Grandparent + 3 Children) $15.00 Junior U18 Pay By EFT Bendio Bank (BSB 633-000 A/C 162344949) Pay Via Credit Card or PayPal (Via our PayPay Page) Donate to OSSA Donation Amount - Amounts over $2 are tax deductible.Able to Help OSSA?Please indicate in Box, more than one can be selected.Exhibitions and EventsAdmin / IT / Social MediaGrants / FundraisingNewsletterCollection / CataloguingMembershipGovernment Corporate LiaisonSchool PromotionsOther - enter in box below.Not Right NowOtherHow did you hear about OSSA* Industry Social Media Facebook Social Media Instagram Social Media LinkedIn Friend Other Please let us know how you heard about OSSAAgreement and Signature* By signing I agree to abide by the Constitution of Offshore and Specialist Ships Australia and for my contact details to be published in the Member area of the Website (password protected). www.ossa.org.au Maritime Experience I Have have previous Maritime experience, seagoing or shore based? If so please provide us with some brief details.EmailThis field is for validation purposes and should be left unchanged.
