Membership Form

Membership Subscription Types SMALL $100 (Wine Bar, Small Bar, Restaurant, Café, Function License)
MEDIUM $250 (Small-Medium Hotel, Small-Medium Club, Independent Bottle Shop)
LARGE $500 (Large Club, Large Hotel, Late-trading Hotel, National Chain Bottle Shop)

Select Membership Subscription Memberships valid from 1st July to the 31st June

Full Name of Club, Hotel, Restaurant or Bottle Shop *

Street Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Postal Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Telephone *

Fax

Email *

Your Venues Logo Please supply your venue logo for use on this website. PNG, JPEG or GIF Accepted

Your Venue Image Please supply an image of your venue for use on this website. PNG, JPEG or GIF Accepted

Your website address

Your Facebook Address

Promotional Text

Please describe your venue

Please indicate the following facilities at your venue *

FoodLive MusicEntertainmentTakeaway AlcoholDisability AccessFamily FriendlyAccommodationBeer GardenTAB FacilitiesFunction Room HireRecreation/Sports FacilitiesCourtesy Bus

Payment via Direct Deposit Bank Account Details
BSB 032-529
Account No. 26-7692
Maitland Liquor Accord Incorporated General Account
(when paying by Direct Deposit please quote your business name)

Payment via Cheque Please post cheque to
Maitland Liquor Accord Inc.
PO Box 77
MAITLAND NSW 2320

Your Membership Profile Once payment has been received via either method above we will add or update your listing on this website.

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