Membership Application

Membership Application - Renewing

Use this online application form for a RENEWAL membership to Wildcare Australia Inc.
Thank you for renewing your membership with Wildcare Australia Inc!

Wildcare is a non-profit, 100% volunteer based organisation located in South-east Queensland which is dedicated to the rescue and rehabilitation of sick, injured and orphaned wildlife.

Wildcare undertakes rescue/rehabilitation activities in the following council regions: Gold Coast, Scenic Rim, Logan, Brisbane, Sunshine Coast, Noosa, Ipswich, Redlands and Moreton Bay. We are unable to issue new Rehabilitation Permits outside of these areas.

Please use this online membership application form if you are RENEWING your membership to Wildcare. If your membership expired more than 12 months ago, please use the NEW online membership form option.

Membership fees are listed below:

SINGLE membership (one individual person):

1 year - $40.00

2 years - $80.00

5 years - $200.00

FAMILY membership (1-2 adults and children 14-17 years living at the same address):

1 year - $60.00

2 years - $120.00

5 years - $300.00

You will select the applicable membership level at the bottom of this online form.

Contact Details:

PO Box 2379, Nerang Qld 4211

Emergency Hotline: 07 5527 2444

Membership enquiries - please email membership@wildcare.org.au

General enquiries - please email enquiries@wildcare.org.au

www.wildcare.org.au
MEMBERSHIP INFORMATION

Please complete your personal information below. Some sections are required to be completed as marked.
Wildcare Membership No.
You will find this on your Membership Card
MEMBER NO. 1

Please complete details for the first member.
First Name 1*
Last Name 1*
Date of Birth 1*

DayMonthYear
Date
Email Address 1*
example@example.com
Mobile Number 1*

PrefixPhone Number
Home Number 1 (if applicable)

Area CodePhone Number
MEMBER NO. 2 (Family Memberships only)

Please complete details for the second member (Family Memberships only) if applicable. Leave this section blank if completing for a Single Membership.
First Name 2
Last Name 2
Date of Birth 2

DayMonthYear
Date
Email Address 2
example@example.com
Mobile Number 2

PrefixPhone Number
Home Number 2 (if applicable)

Area CodePhone Number
RESIDENTIAL/POSTAL ADDRESS
Residential Address *

Street number and name

Street Address Line 2

SuburbState

Post Code
Postal Address (if different to residential address)

Postal Address

Street Address Line 2

SuburbState

Post Code
Rehabilitation/Wildlife Experience
If you wish to renew your Rehabilitation Permit with WILDCARE AUSTRALIA INC. you will need to apply separately for this. The application form is found on the Wildcare website under the Carers Resources tab. Permit Endorsement applications are assessed based on completed training, experience, knowledge, facilities and the demand for wildlife rehabilitators in the region you reside.

Wildcare will only issue Permit Endorsements for members residing in the South-east Queensland council regions of Gold Coast, Scenic Rim, Logan, Brisbane, Sunshine Coast, Noosa, Ipswich, Redlands and Moreton Bay. Permit Endorsements will only be issued to members aged 18 years and over.
Are you a current member of any other wildlife rescue/rehabilitation group in Australia? If so, please list the name of the group and the species you are endorsed to care for. Please also list if you hold a Permit from DES.*

NoYes - please complete next question
If you answered YES to the question above, please list the name of the group and the species you are permitted to care for.
Disclosures

WILDCARE AUSTRALIA INC. controls access to personal information in order to protect the privacy rights of our volunteers. A volunteer's personal details and matters (such as address, telephone number, permit details, rehabilitation experience, training, rescue/carer records etc) may be released to other relevant wildlife organisations (such as the Department of Environment and Science (DES), RSPCA Queensland, Currumbin Wildlife Hospital, Australia Zoo Wildlife Hospital) if required, as well as Wildcare members (such as Species Coordinators, Management Committee, Hotline Operators and other key volunteers).

By joining WILDCARE AUSTRALIA INC you agree:
- To adhere to the organisation's core values, policies and procedures
- To adhere to the conents of the WILDCARE Volunteer Manual and appropriate species training manuals when carrying out tasks on behalf of the organisation.
- To adhere to the WILDCARE Safety Management Manual.
- To abide by the rules set out in the following legislation (available to download on the Wildcare website):
  - Queensland Nature Conservation Act 1992
  - Code of Practice - Care of Sick, Injured or Orphaned Protected Animals In Queensland
  - Animal Care and Protection Act 1992
- To the Management Committee of WILDCARE discussing your membership application or renewal with other relevant wildlife organisations such as Department of Environment and Science (DES), RSPCA Queensland and current/previous wildlife care groups that you have been or are a member of (if required).
- To adhere to the organisation's copyright policy which states that all work and tasks performed on behalf of WILDCARE remains the property of the organisation and is protected by copyright laws.
WILDCARE AUSTRALIA INC accepts no liability for any personal injury, death, property damage/loss or financial cost arising from any voluntary work undertaken for or on behalf of the organisation. WILDCARE holds Public Liability Insurance in the amount of $20,000,000.
PAYMENT DETAILS
PayPal is our preferred method of payment. You do not need a PayPal account in order to pay via PayPal, you only need a credit card.

Please do not send cash, cheques or money orders in the post.
MEMBERSHIP LEVELS

Please select the applicable membership level below. Memberships will not be processed without payment.
My Products
prevnext( X )
SINGLE membership - 1 yearOne individual person for 1 year
$40.00AUD



SINGLE membership - 2 yearsOne individual person for 2 years
$80.00AUD



SINGLE membership - 5 yearsOne individual person for 5 years
$200.00AUD



FAMILY membership - 1 year1-2 adults and their dependent children 14-17 years
$60.00AUD



FAMILY membership - 2 years1-2 adults and their dependent children 14-17 years
$120.00AUD



FAMILY membership - 5 years1-2 adults and their dependent children 14-17 years
$300.00AUD



Total

$0.00AUD

Pay with PayPal

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

Membership Application - Renewing

You will select the applicable membership level at the bottom of this online form.

MEMBERSHIP INFORMATION

MEMBER NO. 1

MEMBER NO. 2 (Family Memberships only)

RESIDENTIAL/POSTAL ADDRESS

Rehabilitation/Wildlife Experience

PAYMENT DETAILS

MEMBERSHIP LEVELS