Narungga Nation Aboriginal Corporation Membership Application

Narungga Nation Aboriginal Corporation Membership Application
To become a member of the Narungga Nation Aboriginal Corporation (NNAC) is to join a strong community committed to the preservation and celebration of Narungga culture, heritage, and rights.
First Name*
Surname*
Please provide any other commonly used names or nicknames:
Date of Birth*

DayMonthYear
Place of Birth*
Phone Number*
Email*
Address*

Street Address

Street Address Line 2

SuburbState

Postcode
Family Information
Mother's Name:*
Father's Name:*
Mother's Family
Grandmother's Name:*
Please enter “unknown” if the information is not available.
Grandfather's Name:*
Please enter “unknown” if the information is not available.
Father's Family
Grandmother's Name:*
Please enter “unknown” if the information is not available.
Grandfather's Name:*
Please enter “unknown” if the information is not available.
Declaration:*

I declare that I am eligible for membership, and submit the information above to support my application.Applicant is over 18 years of age (If under 18, please fill in the Youth Membership Application Form)I agree to Narungga Nation Aboriginal Corporation's Code of Conduct
Please refer to the following Narungga Nation Aboriginal Corporation (NNAC) documents relating the the declaration below:
- Code of Conduct
Privacy Statement

We collect your personal information to manage your membership, keep you informed, and provide relevant services and updates. Your information is stored securely and will only be accessed by authorised staff. We will never share your details with third parties without your consent, unless required by law.

By submitting this form, you agree to the collection and use of your personal information in accordance with this privacy statement.
Signature*

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Date of Application*

DayMonthYear
Should be Empty:

Narungga Nation Aboriginal Corporation Membership Application

Family Information

Mother's Family

Father's Family