Required fields are marked with *. Member details Membership/reference number First name* Last name* Address Line 1* Address Line 2 Suburb* State* Postcode* Phone* Email* Membership and payment options Please select a membership type:* Membership options $25 One Year Membership $60 Three Year Membership Payment options If you select credit card as your payment option: you will be contacted by someone from Vision Australia's National Contact Centre to arrange your payment. If you select direct payment as your payment option: you will need to transfer your payment as an EFT payment. The Vision Australia bank details are: National Australia Bank (NAB) BSB: 083-004 Account: 51-542-6465. Please ensure you put your full name as a reference on the direct payment. Please select your payment type:* Payment options Credit card Direct payment Criteria and Conditions I have attained the age of eighteen years and wish to apply to become a member of Vision Australia and be bound by, and observe the provisions of the Vision Australia’s Constitution. I acknowledge that the information provided in this application form will be used only for the purpose of administering the requirements of members under Vision Australia’s Constitution. Any personal information collected by Vision Australia will be handled in accordance with the Australian Privacy Principles (APPs) outlined in the Privacy Act and any applicable state or territory legislation. I am aware I can request access to the personal information Vision Australia holds about me. I agree that my personal information can be used or disclosed by Vision Australia as contemplated by/in this form. For further information please refer to Vision Australia’s Privacy Policy. I understand that I do not become a member until my membership application is received by the Company Secretary and approved by the Board of Directors and have paid the membership fee. All membership application and renewal fees are due and payable from 31st July of the relevant year. I request that any notice required or permitted to be given to me by law or under the Vision Australia Constitution should be communicated to me in the following form. I would like all correspondence to be provided in the format indicated below. Email is the default format, please indicate if an alternative format is required: alternative_format Standard print Large print Audio Daisy Braille Privacy By submitting, I acknowledge that any personal information collected by Vision Australia will be handled in accordance with the Privacy Act. I agree that my personal information can be used or disclosed by Vision Australia as contemplated by/in this form. I am aware I can request access to the personal information Vision Australia holds about me. For further information refer to Vision Australia's Privacy Policy. Annual report Vision Australia will supply members with access to its annual financial, directors and auditors reports online rather than in hard copy format. This change is in line with modern business practice. If you do not have access to the internet or would prefer to receive a hard copy of the report please contact Vision Australia on 1300 84 74 66 with your request. Leave this field blank
