Membership Form and Instructions

Professional Membership – for Instructors

Associate Membership – for social dancers

Junior Membership – for 16 years & under only

All members receive reduced entry fees to LDAA run events and competitions

OneMusic license – available to Professional members only

Please fill out and submit the form below.

Then:

Electronic Funds Transfer (EFT) or Direct Deposit at a Westpac branch to:

Account Name:   Line Dance Association of Australia

Bank: Westpac, St Marys NSW

BSB Number:  032-273

Account Number:  348658

Reference: Please include your first initial and surname as a reference

Membership will not be valid until payment is received.

Application for New Member

New Membership/Renewal

New Member

Renewal

Member Number

Membership Type

Associate - 1 Year ($20.00)

Junior 1 Year - ($15.00)

Professional - 1 Year ($30.00)

Title(Required)

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Birth Date(Required)

Interests

Instructor

Choreographer

Social Dancer

Coach

Competitor

Professional Member Details

Dance Club/ Group Name

Website

Facebook

Class Details

Max. file size: 128 MB.

Flyer/Schedule

Max. file size: 128 MB.

OneMusic Blanket License for Classes & Socials is available through the LDAA

Yes

LDAA Blanket License runs from 1 March – 28 February each year. Full class information – including venues and class numbers – along with your full license renewal fees are required by 14 February to ensure your cover with the LDAA Blanket music license for members

New Member Declaration

I hereby apply for membership of the Line Dance Association of Australia Incorporated (the “LDAA”) and have made payment for the applicable membership fees as advised over the page. I declare that, if admitted to membership, I agree to abide by the Association’s Constitution and By-Laws as adopted by the LDAA.

Date