Membership Sign-Up

Please complete all sections below and press submit. This form is for new members and for existing members to update membership.

Contact Information

Name(Required)

First Last

Employer/Region(Required)

Preferred Contact Number(Required)

Preferred Email Address(Required)

Memerbership

Are You a New or Existing Member?(Required)

Existing Member

New Member

Type of Membership(Required)

Full Membership

Working with infants and young children
Working in a transdisciplinary role
Working within a public health service

Associate Membership

Majority of the work is with older children
Working predominantly solely as an OT or PT
Working in an acute or private setting

Facebook Email

To join our private Facebook group, please enter the email address linked to your Facebook account below

Payment

The subscription cost is $30.00 for the year ending 30 June 2025

Direct Debit into Account:
Account Name: VNT GENERAL ACCOUNT
Bank: Westpac Lincoln Road Branch
Account Number: 03-0156-0194577-01
Reference: Please use 'SUBS' followed by your family name and initial (e.g., SUBSMALCOLME)

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Name

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