Carpa | Membership

Membership Application
The Central Australian Rural Practitioners Association Inc. (CARPA) provides a focus for multidisciplinary activity in support of primary health care in Central Australia.

Membership of CARPA is open to all people who are involved in primary health care in central Australia who agree with or support the objectives of CARPA.

Application for membership will be made on this form and will be forwarded to the Core Group Convenor for acceptance. Membership will be valid for the calendar year of acceptance and the following calendar year.

There is currently no membership fee.

There are three ways to apply for CARPA membership.

You can download an Acrobat PDF application form here
You can download a Word DOC application form here
You can choose to fill out the on-line application form below

APPLICATION:

First Name:
Family Name:
Street Address 1:
Street Address 2:
Post Code:
Phone:	Work: Home:
Fax:	Work: Home:
Email: (Work)
Email: (Home)

My prefered contact address is:	Postal Address Fax (work) Fax (home) Email (work) Email (home)

Profession Group:
Other (please specify)

Do you wish to receive the newsletter electronically?	Yes No Not to receive

	In applying for membership I affirm that I support the Objectives of CARPA and agree to abide by all the rules, policy and by-laws of the Association. This membership form will be sent electronically to CARPA for processing. Thank you for your application.

Privacy Statement: CARPA collects this information to be able to supply member services that include notification of conferences, education activities and newsletters. Your preferred contact details may be given to third parties only to enable these functions to be done. No information will be given to outside parties for any other reason. If you have any queries please contact the CARPA Convenor at the above address.