QACC: Individual Members
Email
*
(required)
First Name
*
(required)
Last Name
*
(required)
Mobile Phone
*
(required)
Address Line
Are you renewing membership?
Yes (not required to complete the rest of the form)
No (Complete the rest of the form)
Were you born in Australia? (If yes please complete the next 3 questions)
Yes
No
What is your African/s country of origin?
Why did you come to Australia?
Student
Migrant
Refugee Settlement
Family Reunion
Work Relocation
Other
Do you speak other language/s other than English?
Yes (If yes please specify below)
No
Other language/s spoken
What is your current occupation?
What are your skills or areas of expertise?
What area of QACC's work interest you most?
How do you think you can contribute actively to QACC's work?
Address Line_1
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