Individuals who are full-time students in an academic institution in Australia or New Zealand may apply for Student Membership. Click here to apply for a student membership online, or print this application form, fill it out and post to :
The Treasurer, ASPAC
Address From Here
Name (in full) Prof/Dr/Mr/Mrs/Ms__________________________________________
Address: _________________________________________________________________
_________________________________________STATE______________________
Country: ___________________________________________________________
Postcode: ____________
Email: ________________________________________________
Tel: ( ____) ___________ Fax: (____) ________________
Academic Qualifications:_________________________________________________
Presently Enrolled For: ________________________________________
Name of Educational Establishment:____________________________________________
_____________________________________________________________________
________________________________ Postcode: _____________
NOMINATED________________________________________________________
REFEREES (Applicants are required to provide names and addresses of two academic referees)
1.___________________________________________________________________
2.___________________________________________________________________
I agree to abide by the Rules and uphold the Objectives of ASPAC.
Signature:_____________________________Date:_______________________
Fee of $ ________________ is enclosed.
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FOR OFFICE USE ONLY: Application Acceptance:
Chairperson:_______________________________Date:______________
Secretary/Treasurer: ________________________________Date:____________
State/Regional Representative:________________________Date: ____________