EmailMeForm
AEU Member No.
Employee ID
Date of Birth
DD
/
MM
/
YYYY
Surname
*
Given Name
*
Postal Address
*
Home Phone
Mobile Number
Workplace
Email
Classification
*
Please select
Permanent
Contract
TRT
Tier or Step/Level
eg Tier 9; SSO1/6
Fraction of Time
Automatic Payment by Credit Card
I authorise the Australian Education Union (SA Branch) to make automatic deductions of my AEU subscription from my credit card until further notice.
Please debit my card
*
Monthly
Quarterly
Half-yearly
Card Type
*
Visa
Mastercard
Cardholder's Name
*
Card Number
*
Please use a hyphen to separate as follows:
xxxx-xxxx-xxxx-xxxx
Expiry Date
*
MM/YYYY
Signature
*
Clear