Membership Application

Applicant Details

Company/Entity Name

ABN

ACN

Trading/Brand Name

Name by which customers may know this entity

Type of Business Organisation

Number of Customers

Customer Service Email Address

Customer Service Phone Number

ESC License Issue Date

Licence Exemption Category

If you're not sure what licence exemption category you fall into, or what the Exemption Activity Code is visit the Essential Services Commission's public register and search for your exemption details.

ESC Licence Exemption Activity Code

Company Address Line 1

Please note this information will be available to the public on the EWOV website

Company Address Line 2

Company Suburb

Company Postcode

Company State

Postal Same As Company

Postal Address Line 1

Postal Address Line 2

Postal Suburb

Postal Postcode

Postal State

Website

If you are acting as Agent on behalf of the Applicant, you will need to provide EWOV with a signed copy of the Deed of Appointment [DOC, 138 KB].

Governance Contact

As the Governance Contact, you have ownership for high level membership and governance related communication.

Governance Contact Name

Name of Director, Proprietor, Chief Executive Officer

Agent's Company Name

Governance Contact Position

Governance Contact Email Address

Governance Contact Phone Number

Member Portal Contact

EWOV's Member Portal is where you will manage your EWOV membership. As the Member Portal Contact, you have ownership of the membership account on the Member Portal. You can access all areas and functions including creating logins for other users.

Same as Governance Contact

Member Portal Contact Name

Member Portal Contact Position

Member Portal Contact Email

Member Portal Contact Phone

Address Same As Company

Member Portal Contact Address Line 1

Member Portal Contact Address Line 2

Member Portal Contact Suburb

Member Portal Contact Postcode

Member Portal Contact State

Complaint Handling Contact

EWOV requires contact information of the person or team to handle complaints made to EWOV. Further information on complaint handling will be sent to you once your membership has been accepted and processed. Please provide the phone number of the complaint handler or team that will deal directly with EWOV.

Complaint Handling Contact Name

Name of person responsible for complaints

Complaint Handling Contact Position

Complaint Handling Contact Email

Complaint Handling Contact Phone

Complaint Handling Address same as Company Address

Complaint Handling Contact Address Line 1

The following information is for the primary contact for complaint correspondence that EWOV will send:

Complaint Handling Contact Address Line 2

Complaint Handling Contact Suburb

Complaint Handling Contact Postcode

Complaint Handling Contact State

Accounts Contact

Accounts Contact Name

Accounts Contact Position

Accounts Contact Email

Accounts Contact Number

Accounts Contact Address same as Company Address

Accounts Contact Address Line 1

Accounts Contact Address Line 2

Accounts Contact Suburb

Accounts Contact Postcode

Accounts Contact State

Agreement

If this Application for Membership is accepted in accordance with the Constitution of EWOV Limited, the Applicant becomes a member of EWOV Limited and agrees to be bound by and to comply with the <a href="https://www.ewov.com.au/uploads/main/ewov_constitution.pdf">Constitution of EWOV Limited</a>, including the <a href="https://www.ewov.com.au/uploads/main/ewov_charter.pdf">EWOV Charter</a>. <b>Check this box</b> to consent to EWOV Constitution.

Applicant agrees to be bound by and observe the terms of the Energy and Water Ombudsman (Victoria) Limited Charter. <b>Check this box</b> to consent to <a href="https://www.ewov.com.au/uploads/main/ewov_charter.pdf">EWOV Charter</a>.

The Applicant acknowledges that as a member of EWOV Limited, it has obligations including:<ul><li>Resolving EWOV complaints</li> <li>Paying EWOV invoices, including for complaints-based costs</li> <li>Informing EWOV in a timely manner about changes to information relating to the Application and its business.</li>   </ul> Failure to meet these obligations amounts to non-compliance with your obligations as an EWOV member. Non-compliance with obligations of membership exposes you to court action for specific performance or to possible expulsion from the EWOV scheme. <b>Check this box to consent</b> to EWOV obligations.

The EWOV Privacy Policy explains how we collect, use and handle personal information. If personal information about your staff is provided to EWOV, please ensure that the relevant staff members are aware of the disclosure and of the Privacy Policy. <b>Check this box</b> to consent to EWOV Privacy Policy.

Applicant undertakes to pay the required portion of the Annual Levy as determined by the Board of the Energy and Water Ombudsman (Victoria) Limited in accordance with the Energy and Water Ombudsman (Victoria) Limited Constitution. <b>Check this box</b> to consent to payment of Annual Levy.

Applicant undertakes to pay the Start-Up Levy as determined by the Board of the Energy and Water Ombudsman (Victoria) Limited in accordance with the Energy and Water Ombudsman (Victoria) Limited Constitution. <b>Check this box</b> to consent to payment of the Start-Up Levy.<br/><br/>You can access the current Annual Levy and Start-Up Levy costs at <a href="https://memport.ewov.com.au/joining-ewov/">memport.ewov.com.au/joining-ewov/</a>

[OPTIONAL] By ticking the box, the Applicant agrees to general meeting notices and other governance-related communications being sent from time to time by electronic communications to the Applicant's principal business contact as nominated.

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EWOV SCHEME APPLICATION FOR MEMBERSHIP
In accordance with Electricity Act 2000 (Vic), Gas Industry Act 2001 (Vic), Water Act 1989 (Vic), Victorian Retail Code and General Exemption Order 2017, certain providers of energy and water services are required to become members of the Energy and Water Ombudsman (Victoria) Limited (EWOV) (ABN 57 070 516 175)