DVNSW Individual Membership Form Individual Membership Application 1. Type of ApplicationIf you are unsure about what category you fall into please go to our membership page on our website to read further information. Alternatively, you can give us a call on 02 9698 9777.Is this a new member application or are you renewing your current membership?* This is a new application to become a member of DVNSW I am renewing my membership to DVNSW I am applying to be a* Full Member Associate Member I'm not sure 2. Your DetailsYour name First Last What's your organisation's name?*What's your position?Website Direct LineEmail Address* Do you work in the domestic and family violence sector?*YesNoIf yes, what type of service do you work in? DFV Specialist Service Refuge Crisis Service Women's Support (no accommodation) Women's Service Women's and Children Service Women's Health Service Women's Legal Service Sexual Assault Service Generalist Homelessness Service Counselling Service Specialist Homelessness Service Peak Body Domestic Court Advocacy Service Community Housing Provider Transitional Accommodation Staying Home Leaving Violence Other 3. Category of PaymentTo process your membership fees, we need to understand your current working status. Please choose the option that fits your circumstance best below:*Category A: Full time waged Membership Fee $90 (excluding GST)Category B: Part time waged Membership Fee $45 (excluding GST)Category C: Concession/Student Membership Fee $15 (excluding GST)Do you identify as Aboriginal and/or Torres Strait Islander?*AboriginalTorres Strait IslanderAboriginal and Torres Strait IslanderI do not identify as Aboriginal and/or Torres Strait IslanderCommunications and MarketingDo you consent to being listed on the DVNSW website and publications? (no physical address will be shown)* Yes No 7. Consents and Next StepsTo determine your membership criteria, please click the most relevant to your organisations below:* I use the DVNSW Good Practice Guidelines to inform our practice I use the Our Watch Change the Story framework to inform our practice I know about the DVNSW Good Practice Guidelines but we don't necessarily work with it all of the time I know about the Our Watch Change the Story Framework but we don't necessarily work with it all of the time Terms and Conditions* I agree on behalf of my organisation on the terms and conditions set out in the DVNSW constitution The information I have provided above is a true reflection of how my organisation works and practices Thank you for applying to become a DVNSW member. We will contact you within the next 48 hours to get further information from you. Please have details regarding your organisation available and any staff information that you’d like to add on to your membership.
