LGPA - membership application (individual)

Your details

This Application Form refers to individual membership of the Loss and Grief Practitioners' Association.

Membership is for the financial year 1 July-30 June and includes the LGPA newsletter, access to the Members-only section of the website, and discounts for professional development.

Question Title

* 1. Contact details

Name

Address

Address 2

Town/Suburb

State

Postcode

Preferred phone contact

Question Title

* 2. Gender

Male

Female

Other

Question Title

* 3. Age

Under 20

20-29

30-39

40-49

50-59

60-69

70 and over

Question Title

* 4. What are your reasons for applying for membership?
(Tick all that apply)

Access to professional resources / publications

Peer, collegial and network support

Professional development

Community education

Advocacy

Keep up-to-date with what's happening in the field

Other (please provide details)

LGPA - membership application (individual)

Your details

Question Title

* 1. Contact details

Question Title

* 2. Gender

Question Title

* 3. Age

Question Title

* 4. What are your reasons for applying for membership?(Tick all that apply)

* 4. What are your reasons for applying for membership?
(Tick all that apply)