Student member - Australian Community Workers Association - ACWA leads the development, identity, registration and recognition of the community work profession in Australia

Student membership application

"*" indicates required fields

Step 1 of 3

Personal and Contact Details

Name*

First Last

If you do not have a surname please enter your first name again

Gender

Male

Female

Other

Date of birth*

Email*

Phone*

Address*

Street Address Address Line 2 Suburb / City State / Province / Region Postcode / Zip Country

How did you find out about ACWA?

e.g. TAFE, uni, friend

Qualification

Course name*

As it appears on the qualification certificate

Education provider*

How are you studying this course?*

On campus

Online

Blended

Campus name/location

State

Country

Date course commenced*

Date of expected completion*

Student number or student email*

Payment

The fee for student membership is $20. If you are ineligible, this payment will be refunded.

Student Membership*

ACWA Student Membership — $20

Coupon code

Declaration*

I declare that the information I have supplied on this form is correct. I agree to observe and conform to ACWA requirements. I agree to abide by ACWA’s Code of ethics.

I accept this declaration

Privacy*

I have read and understood the privacy policy available at www.acwa.org.au and consent to ACWA collecting, using, storing and disclosing my personal information in accordance with the privacy policy.

I accept this declaration

Total

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Credit Card*

Card Details

Cardholder Name