MEMBERSHIP

Name *

First

Last

Address *

Postcode *

DOB *

18+ years old only

Phone Number *

Email *

Gender *

Female
Male
Not listed

Gender

Newsletter (preferred delivery) *

Emailed
Posted

Please click on either the FULL MEMBER or ASSOCIATE MEMBER box below:

(1) Desire to be a member of Willum Warrain Aboriginal Association Incorporated and I am applying for admission as a:

FULL MEMBER (with voting rights) I identify as an Aboriginal person

*As a healing place, Willum Warrain supports all Aboriginal members on their journey of self-identification. Please note that this form is NOT a confirmation of Aboriginality. To obtain a Confirmation of Aboriginality please email our coordinator for a copy of our policy.

My Language/Group name:

Do you have any children? *

Yes – Please list their names and DOB below
No

Child/Children details

Do you have a current Working with Childrens Check? *

Yes
No

Please provide your Working with Children Card Number: *

If you do not have a Working With Childrens check please supply two referees to support your membership with Willum Warrain. One referee should be personal, while the other should be from an employer or an Elder. If an employer or Elder can’t be provided, only provisional membership will be given and reviewed after 6 months.

Referee 1. Name *

First

Last

Referee 1. Contact Number *

Relationship to Referee 1. *

––––––––

Referee 2. Name *

First

Last

Referee 2. Contact Number *

Relationship to Referee 2. *

(2) Desire to be a member of Willum Warrain Aboriginal Association Incorporated and I am applying for admission as an:

ASSOCIATE MEMBER (No voting rights) I do not identify as an Aboriginal person

Do you have Aboriginal children? *

Yes – Please list their names and DOB below
No

Child/Children details

Do you have a current Working with Childrens Check? *

Yes
No

Please provide your Working with Children Card Number: *

If you do not have a Working With Childrens check please supply two referees to support your membership with Willum Warrain. One referee should be personal, while the other should be from an employer or an Elder. If an employer or Elder can’t be provided, only provisional membership will be given and reviewed after 6 months.

Referee 1. Name *

First

Last

Referee 1. Contact Number *

Relationship to Referee 1. *

––––––––

Referee 2. Name *

First

Last

Referee 2. Contact Number *

Relationship to Referee 2. *

Clicking the ‘Agree & Submit’ button below confirms that you have read and agree to the above Code of Conduct policy – you understand that your membership can be cancelled if you breach the code and that you are submitting this document which you believe in good faith to be true and correct, and acknowledge that deliberate falsification of this document may have legal consequences.

PLEASE NOTE: You are not able to apply for membership if you are on the Sex Offenders Register (VIC and other jurisdictions) and that you are signing a document that you believe in good faith to be true and correct and deliberate falsification may have legal consequences.

Willum Warrain currently has over 450 Aboriginal members and over 500 non-Indigenous members.

Membership is available to all people over the age of 18 who have lived on the Mornington Peninsula or who have links to this area through work, family or other connections.

We currently have three categories of membership available:-

Full membership for Aboriginal and Torres Strait Islander peoples.

Associate memberships for non-Indigenous kin, friends and supporters.

Organisational membership for business, non-government and government agencies.

Become a Full or Associate member by filling in the membership form below and submitting.

Become an Organisational member by contacting our Gathering Place Coordinator for further information on 5979 1391 or 0403 528 034 or gpc@willumwarrain.org.au

MEMBERSHIP FORM

Please click on either the FULL MEMBER or ASSOCIATE MEMBER box below:

*As a healing place, Willum Warrain supports all Aboriginal members on their journey of self-identification. Please note that this form is NOT a confirmation of Aboriginality. To obtain a Confirmation of Aboriginality please email our coordinator for a copy of our policy.

––––––––

––––––––

PLEASE NOTE: You are not able to apply for membership if you are on the Sex Offenders Register (VIC and other jurisdictions) and that you are signing a document that you believe in good faith to be true and correct and deliberate falsification may have legal consequences.

Title

MEMBERSHIP

Willum Warrain currently has over 450 Aboriginal members and over 500 non-Indigenous members.

Membership is available to all people over the age of 18 who have lived on the Mornington Peninsula or who have links to this area through work, family or other connections.

We currently have three categories of membership available:-

Full membership for Aboriginal and Torres Strait Islander peoples.

Associate memberships for non-Indigenous kin, friends and supporters.

Organisational membership for business, non-government and government agencies.

Become a Full or Associate member by filling in the membership form below and submitting.

Become an Organisational member by contacting our Gathering Place Coordinator for further information on 5979 1391 or 0403 528 034 or gpc@willumwarrain.org.au

MEMBERSHIP FORM

Please click on either the FULL MEMBER or ASSOCIATE MEMBER box below:

*As a healing place, Willum Warrain supports all Aboriginal members on their journey of self-identification. Please note that this form is NOT a confirmation of Aboriginality. To obtain a Confirmation of Aboriginality please email our coordinator for a copy of our policy.

––––––––

––––––––

Click here to view Willum Warrain’s Code of Conduct

PLEASE NOTE: You are not able to apply for membership if you are on the Sex Offenders Register (VIC and other jurisdictions) and that you are signing a document that you believe in good faith to be true and correct and deliberate falsification may have legal consequences.

Title