RWH Senior Medical Staff Association Member Sign-Up Form

RWH Senior Medical Staff Association Member Sign-Up Form

Complete this form to become a member of the Royal Women's Hospital Senior Medical Staff Association, alternatively known as the Tracy Maund Society.
Yes, I would like to become a member of the Royal Women's Hospital Senior Medical Staff Association.

The benefits of becoming a RWH SMSA member include:

1. Quarterly Meetings with Guest Speakers and Refreshments

2. Support the Organisation of the Annual Tracy Maund Oration

3. Subsidised Tickets to the Annual Alumni and Current SMS Social Event

4. Subsidised Tickets to the Annual Senior Medical Staff Association Dinner

5. Subsidised Tickets to the Annual RWH Senior and Junior Medical Staff Dinner

6. Support for Your Fellow Colleagues' Beneficial Projects
Name*

First NameLast Name
Email*
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Phone Number
Please enter a valid phone number.
Employee Number*
Please enter your employee number.
Signature - By signing, I authorise RWH Pay Office to deduct $20.00 fortnightly from my pre-tax salary to be contributed to the Tracy Maund Association. I understand that these fortnightly deductions will occur until such time that I inform the MWU/Payroll Service in writing that I no longer wish for these deductions to continue. The fortnightly contribution is $10.00 – this is an “opt in” decision and these fortnightly deductions from you pay will be credited to the Tracy Maund Association until you decide to “opt out”.

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RWH Senior Medical Staff Association Member Sign-Up Form

Yes, I would like to become a member of the Royal Women's Hospital Senior Medical Staff Association.