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Membership Form 2010-11.pmd

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Membership Form 2010-11.pmd Powered By Docstoc
					                                                                               •   six issues a year of PHAA's peer-reviewed academic journal, the
The Association
                                                                                   Australian and New Zealand Journal of Public Health (refer to PHAA
The Public Health Association of Australia Inc (PHAA) is a non party-              WEBSITE in this leaflet);
political organisation representing more than 40 public health related         •   membership of your local Branch which includes the opportunity to
disciplines.                                                                       participate in local professional meetings;
                                                                               •   the opportunity to join PHAA’s Special Interest Groups;
The Association makes a major contribution to public health as an advocate     •   a discount rate for advertising in intouch and the Australian and New
for public health issues primarily through submissions and by representation       Zealand Journal of Public Health;
on boards, committees and consultative bodies. It acts as a forum for
public health advancement and organises conferences and seminars to
                                                                               •
                                                                               •
                                                                                   reduced registration fees at PHAA Conferences and workshops;
                                                                                   the right to vote and hold office in PHAA;
                                                                                                                                                                 Membership Application
enhance the skills of public health practitioners.                             •   an opportunity to participate in Association and public debates about
                                                                                   the shaping of public health policy and legislation on a state and national
PHAA has Branches in all States and Territories, has overseas members,             basis; and,
and is affiliated with PHA New Zealand, the Australasian Epidemiological       •   membership of an electronic mailing list, including vacant positions;
Association (AEA), Australian Health Promotion Association (AHPA) and          •   website - members only section.
the Australasian Faculty of Public Health Medicine (AFPHM).

PHAA has links with public health associations world-wide and is an active
                                                                               PHERT                                                                             “Public health is the art and science of
member of the World Federation of Public Health Associations.                  •   The purpose of the Public Health Education and Research Trust is to
                                                                                   advance medical and scientific research, with funds being applied to          preventing illness and promoting health
Membership is open to any person who is                                            the recognition and engagement of the contribution made by people
                                                                                   working in the field of public health. More information is on the             through the organised efforts of society”
supportive of the objects of the Association                                       PHAA website.

                                                                               The Trust has gift tax deductibility status and donations are very
Objectives                                                                     welcome. Receipts for tax deductibility are issued for every donation.

(1) to advocate for the reduction of health inequalities across Australia
                                                                                                                                                                 The PHAA is an organisation dedicated
                                                                               Conditions of Student and Aboriginal health
    and international communities;
                                                                               worker membership
                                                                                                                                                                 to the promotion of public health. It is
(2) to encourage research and promote knowledge relating to the                Students and Aboriginal health workers are subscribed to our job email list       also a forum for developing professional
    problems, needs and development of public health;                          and are also given access to our members only section on the website,
                                                                               where PDF files of the Australian and New Zealand Journal of Public Health        and academic networks.
(3) to promote and provide a forum for the regular exchange of views           and other publications are available.
    and information;
                                                                               PHAA Conferences
(4) to promote the development and education of workers in public health;      The PHAA organises at least two conferences per year , the annual
                                                                               conference and a special interest conference. All details of dates, themes,
(5) to promote, maintain and extend the interest of PHAA’s Branches,           venues and speakers will be available in the conference section of the PHAA
    Special Interest Groups and any affiliated organisations;
                                                                               website: www.phaa.net.au
(6) to promote excellence in public health practice; and,
                                                                               Corporate membership
(7) to advocate the objects and policies of the Association.                   Corporate membership entitlements can be obtained from
                                                                               www.phaa.net.au/benefitsJoin.php
Benefits of Membership
Full membership provides you with:
                                                                                                                                                                               ABN 41 062 894 473
•   our on-line monthly newsletter, intouch;
                                                    PHAA MEMBERSHIP APPLICATION
Membership can be applied for either online or by completing this              PHAA WEBSITE: www.phaa.net.au                                                I will abide by the Rules and By-laws of the Association.
application form and posting to the PHAA Secretariat.                          PHAA members are issued with a membership number to access the members
                                                                               only section of the PHAA website which provides an online version of the     Signed __________________________              Date ________
Title: _______ Surname/Business __________________________
                                                                               Australian and New Zealand Journal of Public Health.
Given Names: __________________________________________                                                                                                     Note: Annual renewals are due 1 July. Credit Card and Automatic Renewal
                                                                               MEMBERSHIP SUBSCRIPTIONS (please indicate appropriate category)              Facilities are available.
Name of corporate member representative nominated as voting member             Subscriptions payment must accompany this application.
of the Association for and until further notice.                               Note: Payments are only accepted in Australian dollars.
                                                                                                                                                                                       OFFICE USE ONLY
 _____________________________________________________
                                                                               CORPORATE
                                                                                                                                                               Date Processed:________________________________________
Occupation: ____________________________________________                                For profit                                                 $910
                                                                                        Not-for-profit government agencies                         $665
Place of Employment: ____________________________________                                                                                                   New Members
                                                                                        Not-for-profit community-based organisations               $360
Mailing Address: ________________________________________                                                                                                   Membership information will be sent to all applicants on receipt of their
                                                                               INDIVIDUAL                                                                   subscriptions. Membership covers the period from July to June inclusive.
______________________________________________________                         Full Membership                                                              New members may apply for half yearly subscriptions if they join after 1
                                                                                               Category 1 (Gross income above $75,000)               $260   January. Subscriptions for new members joining after 1 June will be
Phone: ( ) _________________________________                                                                                                                credited the next financial year.
                                                                                               Category 2 (Gross income $65,000-$75,000)             $210
Additional Phone: ( ) _________________________                                                Category 3 (Gross income below $65,000)               $150
                                                                               Associate Membership                                                                     Automatic Renewal Authorisation
Fax: ( ) ____________________________________
                                                                                               (restricted benefits with no access to ANZJPH)        $100                           Please read and sign this section
Email Address: _________________________________________                       Student Membership                                                            I authorise the Public Health Association of Australia Inc., until further
                                                                                               (see instructions below)                               $45    notice in writing, to debit my card account number shown above with the
Gender                       Male        Female                                Aboriginal health worker                                                      subscription fee. My account will be debited on receipt of this form by
                                                                                               (see instructions below)                               $45    the PHAA, then annually, and each July thereafter.
Special Interest Group - SIG subscription is $10 per SIG per year. You
may join any number of SIGs ($10 each). Please tick the appropriate box(es).   (refer to: www.phaa.net.au/benefitsJoin.php for conditions of Students &
                                                                                                                                                             Signature _______________________________ Date ___________
Half yearly rates do not apply.                                                Aboriginal health workers)
                                                                                                                                                             Important note:
   Aboriginal & Torres Strait Islander Health                                  individual or corporate membership                        $ ________          Please mail or fax your signed completed form to:
   Child Health                     Mental Health                                                                          Total     $AUD _________          Public Health Association of Australia Inc.
   Environmental Health             Oral Health
   Health Promotion                 Political Economy of Health                                                                                              PO Box 319 CURTIN ACT 2605
                                                                               *SIG membership is free on an ongoing basis for all students and
   Food & Nutrition                 Justice Health                             Aboriginal health workers, and to new members for their first year of         Fax 02 6282 5438
   Injury Prevention                Primary Health Care                        membership.
   International Health             Women's Health                             NB: All membership fees include GST
                                                                                                                                                            Address for all correspondence regarding PHAA Membership:
PHAA MEMBERSHIP DIRECTORY                                                      DONATION: With reduced membership fees you might consider a                  Membership Coordinator
All PHAA members are listed alphabetically in the Directory on the PHAA        donation to Public Health Education and Research Trust (PHERT)
website in the members only section, with details of Corporate memberships                                                                                  Public Health Association of Australia Inc.
listed under the business name provided.                                                    PHERT Donations are tax deductible              $ _______       PO Box 319 CURTIN ACT 2605
Do you wish to be listed in the Directory?            yes     no
                                                                               Please debit my:       Master Card            Visa                           Telephone: (02) 6285 2373
PHAA MEMBERS' ELECTRONIC MAILING LISTS                                             ____________/____________/____________/____________                      Facsimile: (02) 6282 5438
Members supplying an email address will be subscribed to the business and                                                                                   Email: membership@phaa.net.au
                                                                               for the sum of $AUD ______ Expiry date ______ / _____
job advert list & the Branch & SIG list. Those who do not wish to be on the
adverting list will be removed on request.                                     Name on Card ____________________________________ (please print)
                                                                               Signature _________________________________________                          Website: http://www.phaa.net.au
Do you want to receive email job advertisments?       yes       no             or send payment by cheque addressed to: PHAA

				
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Description: Membership Form 2010-11.pmd