Organisational Membership Form

Organisation Name

Website/URL

Name of Primary Contact

Primary Contact Phone

Primary Contact Email

Primary Contact Address

CEO Name

CEO Email

A brief description of your organisation

Please briefly state why you want to be a member of GEN VIC

Do you give your permission for your response to this question be made public on GEN VIC's social media, website and promotional materials? (optional)

Yes

No

Please state how your organisation: advances gender equity; holds values that align with feminist principles; and supports GEN VIC’s vision for equality, health and freedom from violence for every woman and girl in Victoria.

As a member of GEN VIC you have rights and responsibilities. Do you agree to the responsibilities outlined in the GEN VIC Charter of Member Rights and Responsibilities?

Yes

No

Please tick the size of your annual revenue so that we can determine your membership fee (excluding GST)

Please note that organisations may apply for a variation of membership fee dependent on circumstances. Please contact GEN VIC via the contact details below if you would like further information.

Does your organisation support and comply with GEN VIC’s purposes outlined in Part 1, section 2 of the associations rules?

Yes

No

To finalise your application, we ask that an authorised representative of your organisation verifies that all information provided is true and correct.

We're the independent peak body for organisations, practitioners and individuals promoting gender equity in Victoria.

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