Art-Full Women Membership

Art-Full Women is an incorporated organisation run by volunteer members. You are welcome to join us!

Membership is $10. Simply complete the form below, and transfer your membership fee via direct deposit:

Account Name: Art-Full Women Inc.
BSB: 633000
Account number: 191 863 166

Email the bank receipt to lizmullerloth@gmail.com

First Name

Last Name

Street address

Suburb

Postcode

Contact phone

Date fo birth

Membership is $10. Would you like to add a donation? How much?

In an emergency who can we contact?

Emergency contact phone

Emergency contact name

Statistical Information

These questions are not compulsory but will help with application for grants and reports to funding bodies. The information will be stored in our database without identifying information. Thank you.

What country were you born in

Are you an Aboriginal / Torres Strait Islander?

Yes

What is your cultural background?

Do you identify as LGBTQIA?

Yes

Do you identify as having a disability or suffering from a long term health or mental health condition?

Yes

Sign me up for the Art-Full Women Newsletter

Yes please