Existing members wishing to apply for Accreditation may use this form. In this case only sections 1, 6, 7 and 8 need be completed.
To complete this form you will need to check the appropriate level of subscription fees.
New members need to be proposed by a current member. If you do not know any current member of the Society, please contact the Treasurer (treasurer@austms.org.au).
We regret that at present we cannot accept electronic applications as we are not yet able to handle secure transmission of credit card details.
1. PERSONAL DETAILS (Please print or type) Surname: ............................................................ Other names: ........................................................ Title: ........ Degrees and/or Diplomas: ............................................ Current position or occupation: ..................................... Employer: ........................................................... Address for notices and publications (incl. Institutional members): .................................................................. .................................................................. ............................................Postcode: ............ Phone: .............................. Fax: ......................... Email: ..............................................................
2. MEMBERSHIP REQUESTS (Please circle the appropriate responses) I wish to join ANZIAM: YES NO I request reduced-rate membership: YES (see 4. below) NO I request reciprocal membership: YES (see 5. below) NO I wish to be a Sustaining Member: YES NO I wish to become a Life Member: YES NO I wish to become an Education Member: YES NO Institutional Membership is required: YES (see 8. below) NO
3. DECLARATION I hereby declare that I accept the obligations of membership of the Australian Mathematical Society, to further and foster the aims and objectives of the Society and to abide by the Constitution of the Society. Date: ................. Signature: ............................... Proposal I, being a member of the Society, propose and recommend the above person for membership of the Society. Name (block letters): ...................................... Signature: ............................................. Note: If required, the Treasurer can sign this proposal.
4. APPLICATION FOR REDUCED-RATE MEMBERSHIP I hereby apply for the reduced-rate annual subscription for the year ended 31 December ..... . I submit the following supporting statement for the information of the Council of the Australian Mathematical Society only, and note that I do not qualify for reciprocal membership of other societies while on reduced rate. I am at present in the ....... year of my course for the degree of ........................... at .................................... The grounds for my application (if other than the above) are ................................................................... ................................................................... Date: ................. Signature: ............................... ENDORSEMENT I, as a member of the Society having personal knowledge of the applicant, certify that the above details are correct. Name: ............................................................. Signature: ........................................................
5. APPLICATION FOR RECIPROCAL MEMBERSHIP I hereby apply for reciprocal member of the Australian Mathematical Society. I am at present a financial member of the ......................................................... (Society) which has a reciprocity agreement with the Australian Mathematical Society. Date: ................. Signature: ...............................
6. QUALIFICATIONS AND EXPERIENCE (This item must be completed by applicants for accreditation or for a different level of accreditation. For such applicants, THREE copies of the application must be submitted. Other applicants for membership should go to Section 8 below.) I wish to apply for accreditation with the Australian Mathematical Society as (Tick one): __ | | A GRADUATE MEMBER (allowing the postnomials GAustMS) -- __ | | An ACCREDITED MEMBER (allowing the postnomials MAustMS) -- __ | | A FELLOW (allowing the postnomials FAustMS) -- If not applying concurrently for membership of the Society: I have been a member of the Society since ...........
QUALIFICATIONS Degree, diploma, etc. University/College Year ..................................................................... ..................................................................... ..................................................................... ..................................................................... (NOTE: Documentary evidence may subsequently be requested. The Accreditation Committee is empowered to request applicants whose qualifications are not from an Australian institution to undertake an examination.)
PROFESSIONAL EXPERIENCE Present position and responsibilities: .............................. ..................................................................... ..................................................................... ..................................................................... ............................. Position held since ................... Previous positions (Name of employer must be given and mathematical aspects must be described for all positions in government and industry. Position, Duties, etc. From To ..................................................................... ..................................................................... ..................................................................... ..................................................................... ..................................................................... .....................................................................
OTHER INFORMATION that may be useful to the Accreditation Committee (Optional) ..................................................................... ..................................................................... ..................................................................... (NOTE: The applicant may forward any other material for the Committee's consideration.)
7. REFERENCE AND DECLARATION I have asked the following person send a reference: ..................................................................... Address/Email: ...................................................... ..................................................................... I understand that no part of the accreditation fee is refundable, whether or not the application is successful. I understand that, if the application is successful, the use of the postnominals is permitted only while I remain a member of the Society, and while I continue to satisfy the occupational requirements described in the Constitution of the Society. I confirm that the information given by me in this application is accurate. Date: ............... Signature: ..................................
8. INSTITUTIONAL MEMBERSHIP Our institution, ................................................. hereby requests Membership of the Australian Mathematical Society as an Institutional Member. Name/position of authorising officer: ............................ .................................................................. Signature: ................................. Date: ............. (Use section 1. above to provide a mailing address.)
9. PAYMENT The total sum for subscription for the current year and for accreditation is $.............. EITHER: 1. I enclose a cheque for $....... made out to the Australian Mathematical Society. OR: 2. Please debit my (circle one): Mastercard Visacard Bankcard American Express Card number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Card Expiry Date: ............................................. Card Holder Name: ............................................. Signature: ........................... Date: .................. Amount: AU$.............
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Any suggestions, complaints etc about this site should be sent to the editor web@austms.org.au Last update: 03/03/04