Government & Parliamentary Alumni Network

Member Registration Form

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* 1. Title

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* 2. First Name

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* 3. Surname

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* 4. Suffix

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* 5. Preferred email

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* 6. Mobile

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* 7. What level of involvement would you like to have in this network?

Low involvement; Kept informed of updates and upcoming events

Moderate involvement; Opt in and out of events and engagements (time permitting).

Actively involved in driving the network and facilitating regular events and communications

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* 8. What is your ability to commit time to involvement in the network?

Low (Annually)

Moderate (Quarterly)

High (Monthly)

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* 9. Please indicate your nearest capital city (select multiple if you commute regularly):

Melbourne

Regionally (Please specify in Other)

Brisbane

Canberra

Sydney

Perth

Adelaide

Hobart

Darwin

Other (please specify)

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* 10. If you are interested in attending events as part of your involvement in the network, please indicate what style of events would be most preferable:

Breakfasts

Lunches

Evening cocktail functions

Networking events

Workshops

Fundraising events

Other (please specify)

Government & Parliamentary Alumni Network

Member Registration Form

Question Title

* 1. Title

Question Title

* 2. First Name

Question Title

* 3. Surname

Question Title

* 4. Suffix

Question Title

* 5. Preferred email

Question Title

* 6. Mobile

Question Title

* 7. What level of involvement would you like to have in this network?

Question Title

* 8. What is your ability to commit time to involvement in the network?

Question Title

* 9. Please indicate your nearest capital city (select multiple if you commute regularly):

Question Title

* 10. If you are interested in attending events as part of your involvement in the network, please indicate what style of events would be most preferable:

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* 11. What are you hoping to gain from your involvement in this network?

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* 12. Other comments and suggestions for the network