Registration - Membership Form 2019-2020

This form is for enrolling for classes or groups and/or becoming a member of Watsonia Neighbourhood House. Please read carefully and complete each entry.

Name - first

Name - last

Street Address

Suburb

Postcode

Home Phone

Mobile Phone

By providing your email address we will send communications such as
newsletters, program information and updates to you by email.

What is your age range?

Emergency contact name and phone number

Do you have any special needs?

Which class/group are you enrolling in?

For which simester are you enrolling?

Where did you hear about us?

If other, please describe

MEMBERSHIP

Our membership gives us strength, and there is greater strength in numbers
As a member you will be supporting us to provide services to community
Membership is for a full financial year July to June at a cost of $10

I wish to become a member of Watsonia Neighbourhood House

YesNo

Watsonia Neighbourhood House respects all personal and confidential information you provide. We will endeavour wherever possible to protect any information you may provide from unauthorised access, loss or misuse. Information collected from you is required for the delivery of services in accordance with our Neighbourhood House operation, for Public Liability and Legal purposes. We may also use this information to conduct research and surveys, so that we may better understand community needs and improve services.

We may take your photo to use for promotional purposes. If you do not wish your photo to be used, please click "No".

By pressing "Submit", you agree to give Watsonia Neighbourhood House permission to use any information collected in this form as described above and agree to be bound by the rules of the Association. A copy of the rules is available here.

Registration - Membership Form 2019-2020

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