PRIDA membership or interest

Thank you for your interest.  Please complete this form and submit. Note that PRIDA respects your privacy and will not share any personal information with third parties. This website is managed under high security protocols.

Existing members, please don't use this form.
 

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First name :	Required
Surname :	Required
Email Address :	Required
Phone number with country code (optional):
Occupation :
State (if Australian):	NSW Vic Qld Tas WA SA ACT NT
Country location:
What connection with PRIDA are you seeking? :	Membership Stakeholder/supporter connection Donor support or sponsorship for PRIDA (generally or for a specific activity/country) Access to a future PRIDA course or other activity - please specify Other - please specify
For those seeking membership:
{FR_AUDIT7}:	{AUDIT7}
{FR_AUDIT8}:	{AUDIT8}
{FR_AUDIT29}:	{AUDIT29}
{FR_AUDIT26}:	{AUDIT26}
{FR_AUDIT27}:	{AUDIT27}
{FR_AUDIT28}:	{AUDIT28}

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We will be in contact as soon as practicable via email to progress your connection. Membership is subject to approval by the PRIDA Board.