Join AAIMH - Organisational Membership

Please complete this AAIMH Membership Application form if you are seeking to join as an organisation and pay your application fee. The form requires details of a CONTACT person for your organisation.

PLEASE NOTE: This form is only for new Organisational memberships.

Membership enquiries      secretary@aaimh.org.au

*Branch AffiliationPlease choose Branch Affiliation according to where your contact person resides
Number of employees


*Annual Report LinkProvide a link to your Annual Report or similar
Is this a National Organisation?

Organisational Details

*Organisation Name
*Address
*Suburb / City
*State
*Postcode
*Country
*Phone
*General Email Address

Contact Person’s Details

*First Name
*Last Name
*Email Address
*Set a Password
*Position in Organisation
InterestsTick if you would like to be included in AAIMH Members Network for professional sharing of information

Supporting Information

Please provide information on your organisation and the reason you would like to become an Organisational Member of AAIMH. Please indicate how your Organisation is involved in Infant Mental Health.

Payment Information

Please accept our terms and conditions, and enter your payment information below.

Total

$150.00 AUD

*Declaration by Applicant