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Application for Membership Form


Please complete all relevant items and click 'APPLY' to have a membership form sent to you.
Alternatively click here to download a membership form
Please note that your membership will not be activated until we have received a signed membership form.
* Last Name:   
* First Name:
    Sex:
Date Of Birth:
Home Address:
Suburb:   Postcode:   
Home Phone:
E-mail Address:
Your Employer:
Department/Unit/Section:
Your Work Address:
Suburb:   Postcode:
Work Phone:
Position:
Which address would you like your mail to
be sent?
HOME   WORK
Are you: Full-time  Part-time  Casual ?
Notes:

On receiving your application the Membership Department will contact you to complete the joining process
* Preferred contact Phone Number:

 

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Authorised and published by Brian Parkinson, Secretary, Australian Services Union, Victorian Authorities & Services Branch, 116 Queensberry Street, Carlton South, Victoria, 3053, Australia
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