Membership application form

Please select what you consider to be an appropriate rate:

• Learned academies - national peak bodies with core HASS interest: $8800
• University partners - institutional membership: $5500
• University faculties and units from non-partner universities: $3300
• National councils, institutions and major peak bodies: $4400
• Research centres, training and collecting institutions: $1100
• Large practitioner and professional associations, learned societies: $1100
• Smaller practitioner, business associations and learned societies: $330

Your organisation's details

Name of organisation:

Enter the name of your organisation, department, faculty, division, or school above.

Name of institute:

Enter the name of your university/institute, if applicable, above.

Postal address 1:

Postal address 2:

Postal address 3:

City:

State: Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Outside Australia

Postcode:

Country: AUSTRALIA ----------- AFGHANISTAN ALBANIA ALGERIA ANGOLA ANGUILLA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ASCENSION AND ST HELENA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA-HERZEGOVINA BOTSWANA BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA, PEOPLE'S REPUBLIC COLOMBIA COMOROS CONGO CONGO, DEMOCRATIC REPUBLIC OF COOK ISLANDS COSTA RICA COTE D'IVOIRE CROATIA CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC EAST TIMOR ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS FIJI FINLAND FRANCE FRENCH GUIANA FRENCH POLYNESIA GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN, ISLAMIC REPUBLIC IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REPUBLIC KOREA, REPUBLIC KUWAIT KYRGYZSTAN LAO, PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAO MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARIANA ISLANDS MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES AND ARUBA NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE ISLAND NORWAY OMAN PAKISTAN PALAU, REPUBLIC OF PANAMA, REPUBLIC OF PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN ISLANDS POLAND, REPUBLIC OF PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT CHRISTOPHER (ST KITTS) AND NEVIS SAMOA, AMERICAN SAMOA, WESTERN SAO TOME AND PRINCIPE SAUDI ARABIA, KINGDOM OF SENEGAL SERBIA/MONTENEGRO SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SPAIN SRI LANKA ST LUCIA ST PIERRE AND MIQUELON ST VINCENT AND THE GRENADINES SUDAN SURINAME SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TANZANIA THAILAND TOGO TOKELAU ISLANDS TONGA TRINIDAD AND TOBAGO TRISTAN DA CUNHA TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES OF AMERICA URUGUAY UZBEKISTAN VANUATU VATICAN VENEZUELA VIETNAM VIRGIN ISLANDS, BRITISH VIRGIN ISLANDS, USA WALLIS AND FUTUNA ISLANDS YEMEN YUGOSLAVIA ZAMBIA ZIMBABWE

Web site:

Number of members:

Principal of organisation

Honorific:

First name:

Last name:

Postnominal:

Position:

Primary contact person

All correspondence will be sent to this person.

Honorific:

First name:

Last name:

Position:

Email address:

Country phone code:

Areacode:

Phone:

Fax:

Secondary contact person

This person will only be contacted if needed.

Honorific:

First name:

Last name:

Position:

Email address:

Areacode:

Phone:

Fax:

SECURITY CODE

Enter the security code: