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Weenthunga Health Network Inc Membership Form

Please complete the details below if you would like to be a member of Weenthunga Health Network Inc. Your email will be used as your login name. * Please note your address will not be published on the website directory, but is required for the Register of Members. First Australians is our preferred term for Aboriginal and Torres Strait Islander people.

Your password must be:

  • Between 8 and 20 characters
  • Contain both alphabetic AND numeric characters
  • May contain the underscore character '_'
First Name  *
Last Name  *
Email  *
Password  *
Confirm Password  *
Street Address  *
Suburb/Town  *
State/Territory  *
Postcode  *

Please fill out one of the next 2 boxes. If you are a student, please tell us which field you are studying.

Health Profession
Health Role
If you are a student, please tell us the following:
Health Course
Anticipated year of course completion
Required fields:
First Australian  *
Weenthunga Inc Rules

 *  As I am applying for Weenthunga Health Network Inc membership, I acknowledge I have read the Weenthunga Health Network Inc Rules and agree to abide by the rules.

Click here to read the Weenthunga Health Network Inc Rules

 

 *  I understand that by providing my email address, other members will be able to access my email address via the directory, and I will receive occasional updates from Weenthunga Health Network.

Please type the letters you see into the box:

 *
* Required Fields