Membership Nomination

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1. I wish to nominate to become a member of RSPCA Victoria! (Required.)

Adult Membership 2022-23

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2. Please enter your details: (Required.)

First Name

Surname

Email

Phone

Address

Suburb

State

Post Code

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3. Are you affiliated with any other organisation or interest group? (As a member, staff, donor etc.): (Required.)

Yes

No

If yes, please specify any affiliations

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4. I agree to accept and abide by the Constitution and Rules of RSPCA Victoria. (Required.)

I agree that I am over 18 years of age and understand my rights and responsibilities as stated in the RSPCA Victoria Constitution.