Personal
Professional
Beneficiary
Payment
Summary
Done
Personal Details
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Professional Details (leave blank if you are yet to be advised)
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Beneficiary Details

The Australian and International Pilots Association ("AIPA") has a Welfare Scheme which provides your designated beneficiary with a payment in the event of your death while you are a financial member of AIPA. This amount is currently $15,000 *however this is subject to annual review by the Committee of Management. You are requested to keep this information up to date in accordance with AIPA's Privacy Policy.

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Subscription Deduction Authority for Mainline Members

I HEREBY AUTHORISE Qantas Airways Limited to deduct from my salary, my subscription to the Australian and International Pilots association (AIPA).

The amount to be deducted in accordance with this Authority will be the amount that the Secretary of AIPA will certify and advise to you, as the amount of the payroll period subscription payable to me in accordance with AIPA’s Rules. This Authority will allow AIPA to access my payroll records for auditing purposes only. All payments made on my behalf, in accordance with this Authority, will be deemed to be payments by me personally.

This Authority will remain in force until revoked by me in writing.

Direct Debit Subscription Authority

By agreeing to a direct debit facility, you request and authorize the Australian and International Pilots Association (AIPA), APCA ID 207337, to arrange for funds to be debited monthly through the Bulk Electronic Clearing System (BECS) from the financial institution account below to pay your AIPA membership fees.

Subscription fees are currently 0.88% of annual gross salary. You agree to pay the amount in monthly instalment; the first of which will be debited on the 16th of this month, or the next month (whichever is sooner) and then subsequently on the 16th of each month.

You understand that AIPA will debit your account in accordance with the payment arrangement between you and AIPA and that both parties will be bound by the terms and conditions set out in the Direct Debit Request Service Agreement.

Click here to read the Direct Debit (DDR) Service Agreement.

Signed
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Application Summary
Personal Details
Name:

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Email:

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Gender:

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Date of Birth:

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Mobile Number:

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Home Number:

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Home Address:

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Postal Address:

Same as above

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Professional Details
Staff Number:

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Airbase:

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Date of Employment:

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Aircraft:

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Aircraft:

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Airline:

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Rank:

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Rank:

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Rank before LWOP:

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LWOP Commencement Date:

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Expected Return Date:

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New Employer:

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Aircraft Type with New Employer:

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Rank with New Employer:

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Benificiary
Name:

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Relationship:

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Email:

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Phone:

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Address:

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Payment Details
Bank Account Name:
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Financial Institute:
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BSB Number:
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Account Number:
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Name:
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Staff Number:
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Agreement

I, {{ Model.FirstName }} {{ Model.MiddleName }} {{ Model.LastName }}, being eligible for membership of the Australian and International Pilots Association (AIPA), hereby apply for membership and undertake to comply with all provisions, conditions and stipulations in AIPA’s Rules currently in effect or as varied from time to time with all lawful directions made under the Rules. Click here to read AIPA Rules.

AIPA’s Privacy Policy

The above information is collected for the purpose of processing an application for your membership of AIPA. The information collected will be stored in AIPA's membership database. AIPA uses your information for the primary purpose of communicating with you and advising you of the benefits associated with membership. You will be able to update your personal information stored in AIPA's database each time you log in to AIPA's website. Any changes you make to your personal information via the website will automatically update AIPA's database. You can also update your personal information any time by telephoning AIPA. Upon becoming a member of AIPA, you authorise AIPA to collect personal information about you from the Qantas Group, relevant to the personal information you have already provided to AIPA, and to modify AIPA's database accordingly. AIPA will not disclose any personal information obtained from you to a third party without your consent. AIPA's Privacy Statement can be viewed at www.aipa.org.au.

Signed
Signature
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