Username *

Email Address *

First Name *

Last Name *

Are you An Australian Business?
If you are not an Australian Business, please get in contact from the Contact Page with a brief explanation as to why you'd like to promote the Southern Cross Flag and we will get back in touch. * Are you An Australian Business?
If you are not an Australian Business, please get in contact from the Contact Page with a brief explanation as to why you'd like to promote the Southern Cross Flag and we will get back in touch.

What is Your Business Name? *

What is your Australian Business Number (ABN)? *

What is Your Business Type? *
CompanyPartnershipSole TraderTrustNon Profit

Are you registered for GST? *
YesNo

Business Phone *

Business Web Site &/or Shop Page *

I have read and agree to the Terms and Conditions * I have read and agree to the Terms and Conditions

I am subscribing to the Business Members email list * I am subscribing to the Business Members email list

I am authorised to make this application. * I am authorised to make this application.

Registration confirmation will be emailed to you.