Upgrade My Membership

Upgrade My Membership

Membership Information
Please select a membership option from the list below*

Contact Information
Title*
Name*

First NameLast Name
Email address *

Confirmation EmailPlease re-type your email for confirmation
Date of Birth*

DayMonthYear
Diabetes Type*
Phone Number
Either a home number OR mobile is required
Mobile Number
Either a home number OR mobile is required
Home address*

Street Address

Street Address Line 2

CityState

Post code
Do you hold a concession card?*
Concession card type*
Concession card number*
Concession Card Expiry

DayMonthYear
Would you like to add a donation?*

Of courseNo thank you
Donation amount

Concession Information
Concession eligibility

You may apply for a concession membership if you:
- hold a vaild concession card
- are aged between 22 and 26
- are aged 65+
Please select your concession status:
Concession card type*
Concession card number*
Concession Card Expiry*

DayMonthYear
Date
Membership Price
Concession Membership Total

Full Membership
Enjoy the full suite of membership benefits, including:
- 15% off at Diabetes Victoria Clinic.
- A physical subscription to our seasonal membership magazine.
- Our monthly, expert written, e-newsletter, delivered to your inbox.
- Exclusive online content, recipes and videos.
- Partner offers including 10% off at Savers and various benefits throughout the year.
- Online rewards program with discounts from over 200 retailers
Membership Price
Full Membership Total

Family Membership
Family eligibility

Enjoy the benefits of a family membership if there is more than 1 person living with diabetes in your household.
Membership Price
Family Membership total

Health Professional Membership
Health Professional eligibility

You are eligible for health professional membership at Diabetes Victoria if you are a health professional working in the diabetes space. For example: dietitian, general practitioner, diabetes nurse educator, endocrinologist.
Occupation*
Please enter your occupation
Membership Price
Health Professional Total

Complete your membership application
Would you like to include a donation?*

Of courseNo thank you
Free Member Donation Amount
Please enter the amount you wish to donate
Form Calculation

Auto renew membership

Yes
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Membership Calculation
Total Calculation
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