1. Please provide the following details for your organisation.
2. Please provide the following details for the organisation's Chief Executive Officer (or equivalent)
3. Please provide details of a nominated Board authorised delegated representative who will be primarily responsible for Governance responsibilities and having voting rights at the CheckUP AGM
4. Please provide details of the individual who will be primarily responsible for Finance (e.g. membership renewal and event registration payments)
5. Please provide the following details for the membership contact person you wish to receive all correspondence relating to your CheckUP membership.
6. Please provide details of any other staff members you would like recorded in our database and to receive our eNews
If you have more than 3 additional staff to add to our database please provide their details in an email or spreadsheet to email@example.com