My ASG subscription form

Australian Scholarships Group
Friendly Society Limited
ABN 21 087 648 879 AFSL No. 236665
Registered Office: 23-35 Hanover Street Oakleigh Vic 3166
Ph: 131 ASG (131 274) Fax: 03 9563 2780
subscription form
Date: //
Please complete the subscription form and the subsequent ASG Direct debit request form and return to ASG via mail to:
23-35 Hanover St, Oakleigh, Vic 3166
*Denotes mandatory field
Product details
My ASG Subscription $29.95
Title* (eg. Mr/Mrs/Ms)
Given name*
Date of birth (DDMMYY)
Mobile phone number*
Alternate phone number
Email address*
Residential address line 1
Residential address line 2
Applicant’s Signature*:
By signing this subscription form you acknowledge and agree that:
1. All of the information supplied in this subscription form is true
and correct;
2. As soon as payment is confirmed, your subscription to My ASG
will begin;
3. This application and these terms and conditions shall be the basis
of the contract between you and ASG’s Educational Resources
Pty Ltd, the Issuer of My ASG. Your subscription to My ASG does
not provide you with membership of the Australian Scholarships
Group Friendly Society Limited;
4. If you have selected the auto-renewal payment option, your credit
card/bank account shall be debited automatically on the renewal
date. This is every 12 months from the date of commencement
of your subscription. ASG will notify you of the subscription fee in
writing 21 days prior to the automatic renewal date, unless you
cancel your subscription;
5. If you have selected the once-only payment option, you will be
notified 21 days prior to your subscription ending with the option
to renew your subscription and the fee payable for the next twelve
month period;
6. You can cancel your subscription by calling 131 ASG. If you cancel
your subscription at any time prior to the renewal date, you will not
be entitled to a refund of part or all of the subscription paid;
7. You will be notified of any fee change by notice in writing from
ASG from time to time;
8. The information you have provided will be used in accordance
with ASG’s Privacy Policy detailed at
This includes the use of your information for direct marketing,
promotional and research purposes;
9. You consent to the receipt of emails and electronic
communications from My ASG containing information and offers
about products and services available on the My ASG website in
which you may have an interest;
10.The products and services offered through My ASG are offered
by ASG partners, and that any contract for the subscription for a
product or service is between you and ASG partner of that product
or service and that ASG is not a party to that contract;
11. ASG and its subsidiaries, employees and agents will not be liable
in contract or tort (including negligence), equity or on any other
basis to you or any other person for any loss, injury or damage
arising from or as a consequence of any act or omission by ASG or
any person providing services through the My ASG website;
12. All offers made, contracts concluded and services provided
through the My ASG website shall be deemed to be made and
provided in Australia notwithstanding the location of you or the
publisher or the distributor or any other person, shall be governed
exclusively by Australian law, and the Courts of Australia shall have
exclusive jurisdiction to determine any such matters involving or
alleged to involve My ASG;
13. To the extent permitted by law, ASG and/or its partners exclude
all liability for any direct, indirect, punitive, incidental, special,
consequential damages, or any damages whatsoever including
without limitation, damages for loss of life, data or profits, arising
out of or in any way connected with the use or performance of the
MY ASG website, the delay or inability to use the My ASG website,
the provision of or failure to provide the goods or services, or any
information, software, products or services obtained through the
My ASG website.
14.These terms and conditions may be modified from time to time.
You are responsible for regularly reviewing these terms and
conditions and you agree to any such modification.
Australian Scholarships Group
Friendly Society Limited
ABN 21 087 648 879 AFSL No. 236665
Registered Office:
23-35 Hanover Street Oakleigh Vic 3166
Ph: 131 ASG (131 274) Fax: 03 9563 2780
Direct debit request form
for My ASG subscription
Subscription ID
I/We authorise and request Australian Scholarships Group Friendly Society Limited, Debit User ID 002857, to arrange for funds to be debited from my/our nominated
account through the Bulk Electronic Clearing System (BECS) at the financial institution shown below according to the schedule specified below.
Given names
Payment options: (please select one option)
Bank account details:
Bank account holder
BSB number
Name and branch of financial institution
Account number (maximum of 9 digits)
IMPORTANT: Credit union account holders please check with your institution for your
correct BSB and account number
Print name of account holder
Signature of account holder
Note: If debiting from a ‘two to sign’ account, both signatures are required.
Credit card details:
Card holder’s name
Please mark correct box
Full credit card account number (16 digits)
Expiry date:
Note: ASG will charge you 0.66% per transaction amount to cover the cost of the merchant fee payable in offering this service.
Print name of credit card holder
Signature of credit card holder
Subscription fee
Amount $
Once only
Note: ASG will contact you prior to your renewal date to invite and/or confirm for the next twelve month subscription.
Do you want to replace existing account details?
Special notes:
Note: ASG’s Direct debit request form must be forwarded
via mail to: 23-35 Hanover St, Oakleigh, Vic 3166
This form should be read in conjunction with the ‘Member direct debit service agreement’, which is provided to you.
Member direct debit service agreement
Our commitment to you
This document outlines our service commitment to you, in respect
of the direct debit request (DDR) arrangements made between
Australian Scholarships Group Friendly Society Limited Debit User ID
002857 and you. It sets out your rights, our commitment to you, and
your responsibilities to us together with where you should go
for assistance.
Initial terms of the arrangement
In terms of the DDR arrangements made between us and signed by
you, we undertake to periodically debit your nominated account with
the agreed amount for payment of your subscription as specified in
the direct debit form within this document.
Drawing arrangements
• The first drawing under this direct debit arrangement will occur on
the first working day of the month. Subsequent drawings under
this arrangement will occur on the first or 15th working day of the
anniversary month.
• If any drawing falls due on a non-business day, it will be debited
to your account on the next business day following the scheduled
drawing date. If you are unsure when a drawing date will take
place, you may contact ASG on 131 ASG (131 274), or if you are
unsure when the debit will be processed to your account, you
should contact your financial institution.
• We will give you at least 14 days’ notice (in writing) when other
changes to the initial terms of the arrangement are made. The
notice will state what the changes to the initial terms are.
• If you wish to discuss any changes to the initial terms, please
contact ASG on 131 ASG (131 274).
Your rights
Changes to the arrangement
If you want to make the following changes to the drawing arrangements,
contact us five days prior to the scheduled drawing date:
deferring the drawing; or
stopping an individual debit; or
suspending the DDR; or
cancelling the DDR completely.
altering the DDR.
Email: [email protected]
We may send notices either electronically to your email address or
by ordinary post to the address you have given us. Any notice will
be deemed to have been received on the third banking day after
emailing or posting.
• If you believe that a drawing has been initiated incorrectly, we
encourage you to contact ASG on 131 ASG (131 274).
• If our investigations show that your account has been incorrectly
debited, we will arrange for the financial institution to adjust your
account accordingly. We will also notify you in writing of the
amount by which your account has been adjusted. If, following our
investigations we believe on reasonable grounds that your account
has been correctly debited, we will respond to your query by
providing you with reasons and copies of any evidence for
this finding.
• If we cannot resolve the matter, you can still refer it to your financial
institution, which will obtain details from you of the disputed
payment and may lodge a claim on your behalf. Your financial
institution should respond to you with an answer to your claim:
• within seven business days (for claims lodged within 12 months
of the disputed drawing); or
• within 30 business days (for claims lodged more than 12 months
after the disputed drawing).
• You will receive a refund of the drawing amount if we cannot
substantiate the reason for the drawing.
Note: Your financial institution will ask you to contact us to resolve your
disputed drawing prior to involving them.
Your commitment to us
It is your responsibility to ensure that:
• your nominated account can accept direct debits as debiting
through the Bulk Electronic Clearing System (BECS) is not available
on all accounts (your financial institution can confirm this); and
• on the drawing date there is sufficient cleared funds in the
nominated account; and
You can request changes to amounts by logging into My ASG or
contacting ASG.
• you have checked your account details provided in the Direct
Debit Request against a recent statement issued by your financial
institution; and
Direct all enquiries to ASG in the first instance, rather than to your
financial institution, and these should be made at least five business
days prior to the next scheduled drawing date.
• you advise us if the nominated account is transferred or closed.
All communication addressed to us should include your
membership number.
All personal member information held by us will be kept confidential
except for information provided to our financial institution to initiate
the drawing from your nominated account, or in connection with a
claim made on it relating to an alleged incorrect or wrongful debit.
(See the Privacy Policy at
If you wish to notify us in writing about anything to this agreement,
you should write to us at:
Australian Scholarships Group
Post: 23–35 Hanover Street, Oakleigh VIC 3166
If your drawing is returned or dishonoured by your financial institution,
you may be charged a fee/and or interest by your financial institution,
and the cost incurred by ASG will be passed on to you. If this occurs
ASG will send you a letter advising that the drawing has been
unsuccessful and of the charges that we intend to recover from you.
If your drawing is returned or dishonoured once, your next period’s
contributions will collect any arrears for the dishonoured contribution,
along with your regular contribution. If the second attempt to direct
debit your account also dishonours, your direct debit arrangement
will be cancelled. You may contact ASG to re-establish your direct
debit arrangement or alternatively you can set up a new arrangement.
If any provision of this direct debit request service agreement
(DDRSA) is found to be illegal, void or unenforceable for unfairness or
any other reason (for example, if a court or other tribunal or authority
declares it so), the remaining provisions of this DDRSA will continue to
apply to the extent possible as if the void or unenforceable provision
had never existed.