Affiliate Application

Contact:

First Name: *

Surname: *

Position in Company: *
---OwnerDirectorManagerOther, please specify

If other, please specify:

Company Name: *

ABN: *

Street No/PO Box: *

Town/Suburb: *

State: *
ACTNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia

Postcode: *

Telephone: *

Email: *

Website (websites that promote accommodation other than HAA members are not accepted): *

Business category: *
---Booking and digital marketingCleaning and maintenanceElectronic goodsFinancial and legal servicesFurniture and white goodsGuest amenitiesInsuranceManchesterPhotography and video promotionsPrinting and designProfessional developmentPromotional productsQuality assuranceReal estate agents and property managersSecurityTelephone and UtilitiesWebsite development

Description of product or service: *

Details of discount or special arrangement for HAA members: *

Product or service availability: *
[radio* availability default:1 "Australia-Wide" "State Only (select from below)"]

State or Territory:
---ACTNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia

How did you hear about HAA?: *
---Google SearchRecommended by a member of HAAWord of mouthOther, please specify

If other, please specify: *

I have read the HAA Privacy Statement:*
yes

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