General FAMILY Membership

The General family membership is for more than one person from a household that attends events held by the Association.   

Please enter all people under this membership on the form below. 

If you attend a Stroke Recovery Club/group/choir, you can get a Club membership here.

If you would prefer to make payment over the phone, please call 1300 650 594.

Price:

$30

First Name:* First Name Required

Last Name:* Last Name Required

Title (Primary contact person):* Title (Primary contact person) is Required

First Name (Primary contact person):* First Name (Primary contact person) is Required

Last Name (Primary contact person):* Last Name (Primary contact person) is Required

Name of additional person on membership and the relationship to the primary contact: Name of additional person on membership and the relationship to the primary contact is not valid

Year of birth (optional): Year of birth (optional) is not valid

Address Line 1::* Address Line 1: is Required

Address Line 2:: Address Line 2: is not valid

State:* State is Required

New South WalesVictoriaAustralian Capital TerritoryQueenslandSouth AustraliaWestern AustraliaNorthern TerritoryTasmania

City::* City: is Required

Postcode:* Postcode is Required

Primary phone number:* Primary phone number is Required

Select all that apply to people in this membership. I am a:* Select all that apply to people in this membership. I am a is Required

Stroke Survivor Carer Health Professional Volunteer

Would you like to be on the weekly online group mailing list?:* Would you like to be on the weekly online group mailing list? is Required

Yes No

I would like to receive newsletters by:* I would like to receive newsletters by is Required

Email Mail Both mail and email

Would you like to receive information about Aphasia NSW?: Would you like to receive information about Aphasia NSW? is not valid

Yes No

Is your background culturally or linguistically diverse?: Is your background culturally or linguistically diverse? is not valid

Yes No

Are you of Aboriginal or Torres Strait Islander descent?: Are you of Aboriginal or Torres Strait Islander descent? is not valid

Yes No

I acknowledge that I have read and understand the Stroke Recovery Association’s COVID-19 vaccination policy (https://strokensw.org.au/wp-content/uploads/2022/08/COVID-19-policy.pdf). *

I agree to abide by the policies and procedures of the Stroke Recovery Association and understand that my details are kept on a confidential database of members as required by the Associations Incorporation Act 2009 and the Associations Incorporation Regulation 2010. *

I give permission for any photos taken of me during Stroke Club/group/choir activities to be used for promotion by the Stroke Recovery Association in publications and/or on social media.

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength  Password must be "Medium" or stronger

This site collects names, emails and other user information. I consent to the terms set forth in the Privacy Policy.

 

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