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To assist us in giving you the best experience from your @work program please indicate which of the following items interest you most :

Shopping	Dining
Nightlife	Accommodation
Entertainment	Health & Beauty
Ticketing	Invitations to exclusive events

Age: 18-24     25-34     35-43     44-50     50+

How did you hear about Energy Australia Social Club:

I hereby give my authorisation to deduct a once off joining fee of $5.50 and ongoing $0.94c per week from my wages until I give written notice that I revoke all rights to the program.

I understand that my membership details will be emailed to me within 48 hours.