TasCOSS Membership Application This application is for TasCOSS Membership. Once completed the application goes before the TasCOSS Board for approval at its next meeting. 1. TasCOSS Membership Classification1.1 Are you applying for Individual or Organisational TasCOSS Membership?* Individual Membership Organisational Membership 2. TasCOSS Individual Membership2.1 Full Name*Please provide the full name of the individual applying to be a member of TasCOSS. First Name Surname 2.2 Email Address*Please provide the email address of the individual applying to be a member of TasCOSS. Enter Email Confirm Email Address 2.3 Phone Number*Please provide the phone number of the individual applying to be a member of TasCOSS.2.4 Street Address*Please provide the street address for the main office/residence of the individual applying to be a member of TasCOSS. Street Address Suburb State Postcode AfghanistanAlbaniaAlgeriaAmerican 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 RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican 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 RicoQatarRomaniaRussiaRwandaRéunionSaint 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 IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 2.5 Postal Address (if applicable)Please include the postal address of the individual applying to be a member of TasCOSS (if different from street address provided above). Postal Address Suburb State Postcode AfghanistanAlbaniaAlgeriaAmerican 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 RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican 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 RicoQatarRomaniaRussiaRwandaRéunionSaint 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 IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 2. TasCOSS Organisational Membership2.1 Organisation Name*Please provide the name of the organisation applying to be a member of TasCOSS.2.2 Organisation Street Address*Please provide the street address for the main office/residence of the organisation applying to be a member of TasCOSS. Street Address Suburb State Postcode AfghanistanAlbaniaAlgeriaAmerican 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 RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican 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 RicoQatarRomaniaRussiaRwandaRéunionSaint 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 IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 2.3 Organisation Postal Address (if applicable)Please include the postal address of the organisation applying to be a member of TasCOSS (if different from street address provided above). Postal Address Suburb State Postcode AfghanistanAlbaniaAlgeriaAmerican 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 RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican 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 RicoQatarRomaniaRussiaRwandaRéunionSaint 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 IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 2.4 Designated Member Full Name*Each Organisational Member of TasCOSS has one vote. The Designated Member votes of behalf of the organisation in a TasCOSS election. Please provide the full name of the Designated Member. First Name Surname 2.5 Designated Member Position/Job Title*Please provide the position/job title of the Designated Member.2.6 Designated Member Email Address*Please provide the email address of the Designated Member. Enter Email Address Confirm Email Address 2.7 Designated Member Phone Number*Please provide the phone number of the Designated Member.2.7 Board Chair/President Full Name*Please provide the full name of your organisation's Board Chair/President.2.8 Board Chair/President Email Address*Please provide the email address of your organisation's Board Chair/President. Enter Email Address Confirm Email Address 2.9 Organisation Key ContactsAs an Organisational Member of TasCOSS, all staff and volunteers will be treated as TasCOSS Members if your application is approved. Please provide contact details for people at your organisation in the areas of Human Resources (HR), Communications, Finance and any others you think would benefit from direct contact with TasCOSS. Please include each person's title, given name(s), surname, position/job title, contact email and phone number. Alternatively, upload a Microsoft Word or PDF file with a list of contacts for your organisation below.Upload Supporting Document(s) Drop files here or 2.10 Organisation Website URL (if applicable)Please provide the website URL for your organisation. 2.11 Australian Business Number (ABN)*Please provide the Australian Business Number (ABN) for your organisation.2.12 Full-Time Staff*How many paid full-time staff work with your organisation? If this field is not applicable, enter '0'.2.13 Part-Time Staff*How many paid part-time staff work with your organisation? If this field is not applicable, enter '0'.2.14 Casual Staff*How many paid casual staff work with your organisation? If this field is not applicable, enter '0'.2.15 Volunteers*How many volunteers work with your organisation? If this field is not applicable, enter '0'.3. TasCOSS Membership FeesIndividual TasCOSS Membership Fees Structure Classification Membership Fee (incl. GST) Individual Membership Waged / Employed $75.00 Unwaged / Concession $15.00 Core Annual Income Range Membership Fee (incl. GST) Organisational Membership Less than $50,000 $70.00 $50,001 – $99,999 $120.00 $100,000 – $249,999 $175.00 $250,000 – $499,999 $280.00 $500,000 – $999,999 $390.00 $1 Million – $2.49 Million $575.00 $2.5 Million – $5 Million $705.00 More than $5 Million $990.00 3.1 Classification for TasCOSS Individual Membership*Based on the information provided above, please indicate your classification. Waged / Employed Unwaged / Concession 3.1 Core Annual Income Range for TasCOSS Organisational Membership*Based on the information provided above, please indicate your core annual income range.Less than $50,000$50,001 – $99,999$100,000 – $249,999$250,000 – $499,999$500,000 – $999,999$1 Million – $2.49 Million$2.5 Million – $5 MillionMore than $5 Million4. Questionnaire4.1 What motivated you to join TasCOSS?*[max. 250 words]5. TasCOSS Member Benefits & CommunicationsTasCOSS Member Benefits TasCOSS works with our members to support our state's 10,000-strong community services industry workforce. By joining TasCOSS, you are joining a diverse group of citizens who stand up for equality, brave leadership and our shared humanity. A TasCOSS Membership includes the following benefits: Holding the government to account with strong advocacy and social commentary on issues that matter to Tasmanians, Advocacy for state legislative reform that makes a real, lasting difference and coverage of Tasmanian Government governance and processes, Input on state and federal advocacy campaigns and the opportunity to contribute policy and submissions, Access to member exclusive events, innovative programs and networking opportunities, as well as discounts to workshops and training, Analysis and in-depth commentary about Tasmanian Government policy and budgets, Access to TasCOSS’s extensive online library, The Vault, which features research, analysis, submissions and reviews, Access to TasCOSS’s comprehensive How To Library which provides step-by-step instructions on some of the industry's fundamental requirements; and An invitation to the TasCOSS Annual General Meeting (AGM) and eligibility to nominate and vote in the TasCOSS Board elections. You can read the TasCOSS Member Benefits brochure to find out more.5.1 If successful, would you like to receive a call from a member of the TasCOSS team to discuss TasCOSS Member benefits in more detail?* Yes, I would like to to receive a call from a member of the TasCOSS team to discuss TasCOSS Member benefits in more detail. No thank you, I don't require a call from a member of the TasCOSS team to discuss TasCOSS Member benefits. 5.2 Would you like to receive the fortnightly TasCOSS enews and other occasional communication from TasCOSS about membership, training and events?* Yes, I would like to receive the fortnightly TasCOSS enews and other occasional communication from TasCOSS. No thank you, I'm not interested in receiving the fortnightly TasCOSS enews and other occasional communication from TasCOSS. 6. Declaration & PrivacyDeclaration I confirm that my application for TasCOSS Membership is true and accurate to the best of my knowledge. If successful, I agree to uphold the Objectives, Vision, Purpose and Goals of TasCOSS and abide by the Constitution; and refrain from conduct or action which detracts from the reputation of TasCOSS and TasCOSS Members [NB: The TasCOSS Board may at its discretion remove a TasCOSS Member from the Register of Members who fails to exercise their responsibilities].* I agree to the terms of the declaration.Privacy Policy TasCOSS pledge to respect and uphold your rights to privacy protection under the Australian Privacy Principles (APPs) as established under the Privacy Act 1988 and amended by the Privacy Amendment (Enhancing Privacy Protection) Act 2012. The information provided to TasCOSS will be used for the purposes of assessing eligibility for TasCOSS Membership.* I agree to the privacy policy.Date*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Type and Press “enter” to Search