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Membership Application Form

$4.00 – $15.00

Enter your business details to complete your ATIA Membership Application online.

Billing Preferences

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*Billing Preferences
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Applicant Information
*Business/Individual Name
- $
*Street Address
- $
*City
- $
*State
- $
*Postcode
- $
- Postal Address is same as Street Address $
*Postal Address (if different)
- $
*City
- $
*State
- $
*Postcode
- $
Representative Information
*First Name
- $
*Surname
- $
*Position
- $
*Mobile
- $
Class of Membership
- State Association (Class A2) $
- Network Company (Class B) $
- Licence Owner, Fleet Operator, or other Industry Partner (Class D) $
Applicant's Taxi Services

Trading/Business Names (if different to company name above)
Business Name 1
- $
Business Name 2
- $
Business Name 3
- $
Business Name 4
- $
* The number of Taxi Service Vehicles includes all vehicles owned, operated or affiliated with the member that provide on- demand, personalised (anywhere-to-anywhere), passenger transport services in light vehicles for commercial fares, whether hired from a rank, by a street hail, or via booking / dispatch platform.

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