ALGWA VIC

Membership Application

To apply please complete all questions.
Membership of the Australian Local Government Women’s Association is open to all interested in encouraging and supporting women’s participation in Local Government. Membership is due July 1 of each year irrespective of when you join ALGWA Vic throughout the year.
Reason For Joining ALGWA Vic *
How did you hear about us ? *
Name *

First Name Last Name
E-Mail *
example@example.com
Municipality *
Position / Occupation *
Mobile Number *
Phone Number
Postal Address *

Postal Address

Street Address Line 2

City State

Post Code
Name of individual filling out the form *

First Name Last Name
Email address to receive the renewal and payment receipt *
example@example.com
Payment Method *

Direct Deposit Credit / Debit Card

Credit / Debit Card

Being an individual member gives you opportunity to vote at the AGM and also stand for a committee position every 2 years.
Direct Deposit

Individual 1 Year Membership $85.00 Individual 4 Year Membership $320.00 Individual Concession Membership $40.00 Council 1 Year Membership $370.00 Council 4 Year Membership $1460.00 Rural Council 1 Year Membership $300.00 Rural Council 4 Year Membership $1180.00
Direct Deposit: {amount}

Bendigo Community Bank

Account name: ALGWA Victorian Branch

BSB: 633 000 Account number: 152 248 845
ARE YOU A COUNCILLOR

Yes No
Proof of Concession

Browse Files
Upload your concession information here. Cancel of
Name of Council

Privacy Requirements: The Executive advises that due to the Privacy Act, we are required to have your authorisation to be able to release any information pertaining to your membership or to include your details in any publication. We ask that the following authorisation be agreed to:

I authorise ALGWA Vic Branch to release my contact details to other ALGWA members, other organisations, or persons for matters pertaining to the Association’s interests.
Signature *

Clear
FOLLOW US
This Membership has been pre-approved and you will be formally advised within 28 days of ALGWA Vic receiving this completed form with payment.
Patron: Honourable Linda Dessau, AC, Governor of Victoria

President: Cr Kylie Spears

Mobile: 0436 003 660
P.O. Box 603 Templestowe 3106, Victoria
All correspondance including all acount queries to Executive Officer admin@algwa.com.au
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Membership Application