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Victorian Womens Health Atlas

Equality and Safety for Women website

Membership Application / Renewal 2016 – 2017

Membership is free.

Membership is for one year effective from the day after the AGM (Nov 2016) until the next AGM (Nov 2017).

Fields marked with an asterisk ( * ) are mandatory

1. New or renewing? *
2. Membership category *
3. Name of individual member / organisational contact
4. Contact details
5. Statement of Purposes *
6. Membership terms

1. Women’s Health Victoria is a women’s only organisation.
Membership (and organisational member representation) is for women only.
Equal Opportunity Exemption No. H102 of 2014.

2. I/We desire to become a member, or renew my/our membership, of Women's Health Victoria for the year ending at the 2017 Annual General Meeting.

3. As a member, I/we shall at all times comply with the Women's Health Victoria rules.

4. I/We accept that Women’s Health Victoria's Constitution requires that my/our name, address and date of entry shall be kept in a membership register. The register is available for inspection by the members for the purposes of Women's Health Victoria at Women’s Health Victoria's registered address.

Privacy statement: Women's Health Victoria is committed to protecting your privacy and the confidentiality and security of personal information provided by you to us. In terms of the relevant privacy legislation, we ensure that your personal information will not be disclosed to others, except if required by law or other regulation.

7. Agreement to membership terms *

Await confimation:
Your membership / renewal status remains "pending" until your application is processed and you receive confirmation via email.