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. We do not offer Pro-rata due to the size of our organisation.
Reason For Joining ALGWA Vic*
How did you hear about us ?*
Name*

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

Postal Address

Street Address Line 2

CityState

Post Code
Name of individual filling out the form*

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

Direct DepositCredit / 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 $100.00Individual 4 Year Membership $350.00Individual Retired Councillors Membership $50.00Metro Council 1 Year Membership $750.00Metro Council 4 Year Membership $3,000.00Regional Council 1 Year Membership $500.00Regional Council 4 Year Membership $2,000.00Rural Council 1 Year Membership $350.00Rural Council 4 Year Membership $1,400.00
Direct Deposit: {amount}

Bendigo Community Bank

Account name: ALGWA Victorian Branch

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

YesNo
Proof of Concession

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Upload your concession information here. Cancelof
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.

Membership Application