Autism NT Membership

Autism NT Membership page

Membership of Autism NT provides access to library resources, discounted information sessions and regular updated information as we receive it.

Personal Details

Given Name	Required
Surname	Required
Street or PO Box	Required
Suburb	Postcode Required
Home Phone		Mobile Phone
Work Phone		Email
Preferred method of contact
Type of membership
Screen name on the Message Board
Password		Retype password
Email address viewable on the Message Board?

Person(s) identified with ASD

The following information is used for the purpose of data collection which may be shared with other organisations. This information is voluntary and you may provide as much or as little as you wish.

Add a person

Person one

	Given Name
	Surname
	DOB
	Medical (dis)ability
	Age diagnosed
	Diagnosed by	Paed Psych Diagnostic Team Self
	Diagnosed where

Add another person

Person two

	Given Name
	Surname
	DOB
	Medical (dis)ability
	Age diagnosed
	Diagnosed by	Paed Psych Diagnostic Team Self
	Diagnosed where

Add another person

Person three

	Given Name
	Surname
	DOB
	Medical (dis)ability
	Age diagnosed
	Diagnosed by	Paed Psych Diagnostic Team Self
	Diagnosed where

Please note;

	A single membership payment, whether a family / student or organisation means entitlement to one vote at the annual general meeting. Autism Northern Territory financial year reflects the celender year. All membership fees are due in January. Only people over 18 years of age are eligible for financial membership. Organisation membership includes benefits for more than one staff member. Autism Northern Territory (Inc) is a charitable, non government, not-for-profit organisation.
	Do you agree to these terms?	Required

Membership Fees

Membership types

Family Membership which covers everyone in a family. Fee: $25 per year.

Carer Membership for a carer of someone with ASD. Fee: $25 per year.

Professional Membership for organisations and professional entities. Fee: $50 per year.

School Membership for schools Fee: $50 per year.

Student / Pensioner Membership for people who are concession card holders, or students. Fee: $15 per year.

Payment methods

You may pay your membership fees using any of the below options;

Cash, payable at the Autism NT office during operating hours
Cheque or Money Order - Can be either dropped in at the office or posted to: AutismNT PO Box 36585 Winnellie NT 0821
Direct Debit - Can be transferred directly into our account. Please use your Surname as reference. Our account details are available by contacting Autism NT on (08) 8948 6624

Your membership will not become active until payment in full have been received.

Page last updated: 20 Aug 2010 | This page has been viewed 1471 times.

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