VCPS Membership Application Form

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Membership Type:
New Member Renewal Change of Address


Journal Subscription:
Digital Journal ($18) Digital + Paper Journal ($30)


Membership Payment: *
Cheque / cash (sent separately) Direct Deposit Via PayPal
Not Applicable (change of address only)
Direct deposit / PayPal receipt or reference number:


Full Name: *


Current Address: *


Phone: *
Please provide your area code (and country code if outside of Australia)
B.H.
A.H.
Mobile

Email Address: *


Additional Comments


Where did you hear about the VCPS? (New members only)


Privacy Consent: *

I consent to my personal details (as above) being shared with other VCPS members for communication purposes only. (They will not be disclosed to any third party.) See the VCPS Privacy Policy for more information.

* Required

Note: Membership is subject to approval by the VCPS Committee.