Membership Form

SNAICC Membership Application Form

Membership type * Member — an Aboriginal or Torres Strait Islander entity that works for childhood development, safety of wellbeingMember — a Director of SNAICCAssociate — a non-Aboriginal or Torres Strait Islander entity that works for childhood development, safety or wellbeingAssociate Individual — a natural person who works for childhood development, safety or wellbeing

See definition of SNAICC membership

Organisation

Include ABN if any

Member / organisation representative *

First Name

Last Name

For example, the CEO of your organisation

Email contact of representative * Please provide a brief description of the purpose and activites of your organisation (no more than 250 words) * Number of Aboriginal and Torres Strait Islander staff 1-1011-2020+

If applicable, please provide an indication of the number of Aboriginal and Torres Strait Islander staff employed

Primary Contact Person *

First Name

Last Name

For example, an executive assistant or finance officer

Address * Address 1 Address 2

City / Area

State

Postcode

Country

Primary Contact Email * Phone / Mobile * Declaration * I agree to the objectives of Corporation Signature *

Accepted file types: jpg, jpeg, png, gif.

Please upload an image of your signature

Date * Sign up to receive alerts and e-news from SNAICC.

SNAICC Membership Application Form

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