• Membership Application Form

    Each paid membership is a single membership for the applicant aged 18+

  • MEMBERSHIP OPTIONS

    AusDoCC Inc memberships are available for adults aged 18 and above. Each membership is a single membership for the person signing up. Details will be collected about yourself if you are the person with the CCD or about relevant children or adults with a CCD

  • Details of Child or Adult with a CCD

  • Child or Adult with a CCD 


  • 2nd Child or Adult with a DCC 


  • Child or Adult 3


  • Contact and Privacy

  • The information collected in this form is for the use of AusDoCC Inc. All information is confidential and will not be shared with any third party without prior consent. AusDocc Inc uses email to share relevant information, resources and newsletters with members, including information about upcoming events and opportunities. The Privacy Act 1988 allows applicants to access and amend their personal information at any time. Please contact info@ausdocc.org.au for a copy of the AusDoCC Privacy Policy.

  • Declaration

  • By signing below, I desire to become a member of AusDoCC Inc. I agree to support the purposes and rules of AusDoCC and accept the terms and conditions of application for membership. I declare that all the information given on this form is true and correct. 

  • Optional Donation - All donations are tax deductible

    Yes, I wish to help AusDoCC Inc. to support all those with a disorder of the corpus callosum and their families.


  • Method of Payment

  • Direct Bank Transfer Details

    Account Name: AUSDOCC INC

    BSB: 013257

    Account Number: 378800587

    Please put your Full name as a reference

     

  • Once you submit this form with payment and your membership has been approved, you will receive a confirmation by post with a membership pack. Please do not hesitate to contact us if you have any questions or concerns.

     Thank you for applying for membership with AusDoCC and supporting our work.

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