Buyer registration form

Are you a current ATEC member?

Yes

Please select a registration type from the below options:

ATEC ITO member

Non-member buyers are not eligible to participate in the ATEC Health & Safety Checklist program. Please contact the ATEC National office for information on how to become a member.

Find out more about ATEC membership

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Company name

Trading name

Company ABN

Contact first name

Contact surname

Job title

Contact email

Company website

Company logo

Company address line 1

Company address line 2

City

State

Postcode

Username

Password

Public liability policy provider

Public liability policy expiry date

Policy territorial limits

Public liability value ($AUD 10m min)

Public liability insurance policy

Professional indemnity policy provider

Professional Indemnity expiry date

Prof. indemnity value ($AUD 5m min)

Professional indemnity insurance policy

Does your business comply with all local, state and national laws, rules and regulations relevant to your business?

Yes

If your business does not comply with relevant local, state or federal laws, rules & regulations then you are ineligible to participate in ATEC's Health & Safety Checklist program.

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Your declaration

By registering for ATEC's Health & Safety Checklist, you agree to the terms and conditions of participation. Please read the terms at the link below and acknowledge by ticking the box. If you have fees to pay, you will be redirected to the cart to finalise your registration.

I have read and accept the Terms of Use and Privacy Policy.

Email address

Buyer Application Form

Your declaration