Feminist Local Action Group Sign Up Form

I would like to (tick all that apply):*

join CBF, the Cyber Feminists (online advocacy flash mob)
join a FLAG in my local area
start my own FLAG

Membership

You must be a YWCA Australia member in order to join a Local Action Group. Membership is FREE and includes a range of benefits, which you can check out here.

Please indicate:*

I am already a member
I agree to becoming a member
I am unsure if I am a member

Disclaimer*

Yes I do
No

Do you accept the values of YWCA Australia and agree to be bound by the terms of membership in the YWCA Australia Constitution? *

Personal Information

Full Name*

First Last

Contact Email:*

Contact Phone*

Date of Birth*

DD

MM

YYYY

Address*

Street Address Address Line 2 City State Postcode Country

About You

Gender*

Prefer to Self Describe

The following question is optional. We use this information to understand more about our membership, which will help us inform our membership activities, our advocacy, and our service delivery.

Do you identify with any of the following:

Aboriginal and/or Torres Strait Islander
Culturally and linguistically diverse
Living with a disability
LGBTIQ+

What issues are you interested in? (multiple choice)*

Do you have any skills or experience you would like to contribute to a Local Group?

Volunteer Information

All YWCA Local Group members are defined as volunteers in order to ensure that they are covered under our organisational insurance policy. To quality as a volunteer, please provide the following information.

Are you prepared to obtain a Police Check or Working With Children check if working with young people?*

Yes
No
I already have a valid check

VOLUNTEER CONSENT: I consent to the collection of my personal information as contained on this form and acknowledge that this information will be held and used in accordance with the relevant YWCA Australia policies, including in order to assist YWCA Australia to identify mutually suitable volunteering opportunities.

I understand that YWCA Australia may require me to attend an interview, as well as complete pre-engagement checks such as a National Criminal History Check and any other workplace checks that are relevant to the volunteer role and working with children. I understand that I will not be able to commence in my volunteer role until any required checks have been completed, or continue if those checks expire.

I understand that by ticking the consent box below and submitting this form, I am consenting to these terms.

Consent*

I consent to the above terms and conditions.

Emergency Contact Details

Emergency Contact Name*

First Last

Relationship to you*

Emergency Contact Phone*

Emergency Contact Email*

Consent

How did you find out about YWCA Local Groups?

By providing your email address and/or mobile number you agree to receive information from YWCA Australia about local groups from time to time via electronic means. If you do not wish to receive information via electronic means please email [email protected] to let us know.