Membership Form
Fill in the details below to be a sign-up as a member of Council on the Ageing NSW:
*
1.
First Name
(Required.)
*
2.
Surname
(Required.)
*
3.
Email
(Required.)
*
4.
Telephone/Mobile Number
(Required.)
*
5.
Postal Address
(Required.)
6.
Are you interested in volunteering?
Yes
No
7.
Are you a member of any similar organisation?
No
Yes, please provide details
*
8.
I understand that by submitting this form:
I am applying for membership of Council on the Ageing (COTA) NSW.
I agree to support the aims and objectives of Council on the Ageing (COTA) NSW as outlined in its constitution, and I commit to abiding by the code of conduct and mission.
I consent to receive communications from COTA NSW including, newsletters, invitations, updates and official COTA NSW membership information.
(Required.)
Yes, I agree
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