Student member

Personal and Contact Details
Name*
First Last
If you do not have a surname please enter your first name again
Gender
- Male
- Female
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

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
$ 0.00
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Credit Card*
Card Details
Cardholder Name

Personal and Contact Details