This form is an application for a Qrun group affiliation as an Associate Member of Queensland Athletic Association Limited (ABN: 11 010 706 751).

Affiliation costs:

• $300.00 (including GST) per annum
  1 October 2021 to 30 September 2022

No payment is required to complete this form.

An invoice will be issued to successful applicants to complete the affiliation process.