APPLICATION FOR MEMBERSHIP
ASSOCIATIONS INCORPORATION ACT 1991, ACT (Reg. No. AO4477)

NAME				
	Title	Family Name	Given Name(s)	

WORKPLACE or  ASSOCIATED INSTITUTION:		

MAILING ADDRESS:	Street Number and Name				
	Suburb/City				
	State/Province		Post Code		
	Country				

EMAIL ADDRESS:		

PHONE NUMBERS (Please include country and area codes):				
Home		Work		
Mobile/Cell				

FIELD(S) AND COUNTRIES OF INTEREST RELATED TO THE PACIFIC AND PACIFIC STUDIES:			

			

I APPLY to join the Australian Association for Pacific Studies Inc., AND I AGREE to receive notices from AAPS by email, and to follow the rules of its Constitution.

			
Date	Signature (typed is sufficient)		

 
WHEN COMPLETED, please email this form as an attachment to Lanieta Tukana (co-secretaries): lmokosoi@gmail.com 
Approved				
	Date	Secretary		

Entered on the List of Members				
	Date	Public Officer