Australian Privacy Foundation home

The association that campaigns for privacy protections

Membership Form

Australian Privacy Foundation Inc.
ABN 38 904 502 598

Membership Application and Renewal Form

Please print this form, fill it in, enclose a cheque, and post it to P.O. Box 3348, Belconnen ACT 2617. (Or you can use our nice printable brochure in PDF format.)

We regret that facilities for on-line application and payment are not yet available. If you prefer to use electronic means, please do so as follows:

For information about the APF, see About APF, and the Members Area.

For the Foundation's Privacy Statement, see below*


To: The Secretary, Australian Privacy Foundation Inc.

Name in which the Membership is to be recorded on the Register of Members:

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If applicant is an organisation, name of Contact Person and title of their position:

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Postal Address: .............................................................................................................

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Email address (optional but strongly preferred): ....................................................

Contact telephone number(s) (optional): .................................................................


I declare that I/we support the Foundation's objects and purposes set out in Rule 3 of the Rules of Incorporation, as follows:

  1. To protect the privacy rights of Australians, by means of research, awareness, education, the highlighting of privacy risks in all forms of technology and practices, and campaigns for new laws, regulations, codes, policies and practices, and amendments to existing laws, regulations, codes, policies and practices.
  2. To focus public attention on emerging issues and technologies that pose a threat to the freedom and privacy of Australians.
  3. To collaborate with consumer organisations, civil liberties councils, professional associations and other community groups on specific privacy issues.
  4. To participate in and contribute to other national and to international privacy protection organisations and initiatives.
  5. To provide information to industry associations and government agencies, and to cooperate with them wherever practicable, but to remain independent of them, and to be critical of them where necessary.
  6. To pursue such additional objects and purposes as may facilitate the achievement of the preceding objects and purposes.

I/we apply for the category of membership ticked below.

I am paying as follows:

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Signature: ......................................................................... Date.................................


Member Involvement

What interests and expertise do you have in the area of privacy?

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Are you prepared to do voluntary work for the APF such as reviewing and preparing comments on discussion papers and submissions?

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Other comments:

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Rules of Incorporation. See the Foundation's Rules of Incorporation, at http://www.privacy.org.au/About/RulesofInc.html

Privacy Statement. Personal information is collected for the purpose of administering the affairs of the Australian Privacy Foundation and communicating with members. It is handled in accordance with the National Privacy Principles. For further details see the Foundation's Privacy Policy, at http://www.privacy.org.au/PrivacyPolicy.html


Categories of Membership and Schedule of Fees

(Please Tick Category of Membership Applied For)

ORDINARY MEMBER

O Annual Fee $40

O Annual Fee - Concession/student (please provide details) $10

O Life Membership Fee $275

ASSOCIATE MEMBER
Not-For-Profit Organisations and Small Organisations (fewer than 5 employees)

O Annual Fee $220

O Life Membership Fee $660

Other Organisations

O Annual Fee $1100

O Life Membership Fee $3300

Donation

O Additional Amount $ ............................

Contribution to specific campaign (please specify):

O Additional Amount $ ............................

Total payment

O TOTAL AMOUNT $ ............................


OFFICE USE ONLY

Application approved: [Date] ........................................

Application fee received: [Amount} ........................................

Method of Payment: Cheque [ ] / Cash [ ] / Direct [ ]

Monies banked: [Date] ........................................

Member notified: [Date] ........................................


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Last Amended: 14 August 2013 by Roger Clarke - Site Last Verified: 11 January 2009
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