Membership

Privacy information: AQuA collects information for its membership records and to be able to contact its members. AQuA will not disclose your personal information without your consent. By applying for membership, you consent to being sent post and emails from time to time by AQuA.

Donations: You can make a donation with your membership. Donations of $2 or more are tax-deductible.

Membership

Membership *

Full - $ 20.00

Concession - $ 5.00

Optional Donation $

Total Amount

Email Address *

Member / Donor Details

First Name *

Last Name *

Phone *

If donors are agreeable, AQuA would like to acknowledge them (but not the donation amount) in AQuA's annual report. Please choose how you would like to be acknowledged.

How to acknowledge donation *

If this donation is in the memory of a colleague, friend or loved one, you can provide their name, which will be included in AQuA's annual report.

In memory of

Credit Card

If you have a PayPal account, you can click the PayPal button to continue. Otherwise, fill in the credit card and billing information on this form and click Continue at the bottom of the page.

Checkout securely. Pay without sharing your financial information.

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

Suburb/Town *

Country *

State/Territory *

Post Code *