Membership Form

Membership Form

Currently, United is the only approved provider of Aged Care Services for Victoria's Spanish Speaking Community by the Commonwealth Government . As the number of members grows, we can provide broader support in order to extend and diversify our services. Thanks to your contribution, we can support the community and make a positive difference.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Date of birth*

DayMonthYear
Date
Country of birth*
Landline
Please enter a valid phone number.
Mobile*
Please enter a valid phone number.
Email*
example@example.com

I {nameAnd} wish to be a member of the Spanish Latin-American Welfare Center Inc. (UNITED).

In the event of my admission as a member, I agree to abide by the rules of the association.
Signature*

Are you a UNITED employee? * If your answer is yes, you will NOT be able to vote to elect the members of the management Committee.*

YesNo

Do you do volunteer work for United? * If your answer is yes, you do not have to pay the membership fee*

YesNo

Thank you for volunteering with United!

The membership fee for volunteers is $0, but if you want to make any donation, we would appreciate it.
If you would like to make a donation, please enter the amount here*
fill with a zero (0) to not send donation
We appreciate any donation you send us, any donation over 2 dollars can be tax deductible

Details
Membership fee ${membershipFee}
Membership Volunteer fee $0 (1 year)
Donation ${ifYou}
Subtotal
The membership fee for volunteers is $0

Please press the Submit button to proceed
Total fee

prevnext( X )
AUD

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.