Individual Membership Application

New Memberships and Renewals.

Application Type *

New Membership
Membership Renewal

Name *

First

Last

Organisations & Associations

Address *

Address Line 1

City

State / Province / Region

Postal Code

Phone *

Email *

Motivation *

VNQ Insurance Declaration

VNQ has current Public Liability and Volunteer Personal Accident insurance providing cover at all VNQ events, activities and volunteer opportunities

Agreement

Agreement *

I agree to support the objects of the organisation
I agree to participate in the annual general meeting

Privacy *

I have read and consent to the collection, use and disclosure of information as described below, to be included in the VNQ membership database, directory of member organisations, and mailing list

>> I understand that the information collected here will not be given to any other agency without seeking my permission, except as required or authorised by law.

>> A copy of VNQ’s Privacy Policy is available on our website or by request at reception@vnq.org.au

Signature *

Your full name name here is your signature for this form.

Individual Membership

Price: $ 19.00

Payment Method *