Membership Program Information

WA Health Promoting Schools Association Inc. Membership Application
Please select either Ordinary (financial) membership or Associate (non-financial) membership
Select membership1
- Ordinary Member
Organisation Member: being those non-government associations, government services, societies, boards, schools at tertiary institutions, or any other bodies, incorporated or unincorporated, which qualify under the rules and have active engagement and interest in school health promotion. (ii) Individual Member: being those persons who do not represent an organisation or fit into the categories below, including industry based-consultant or health sector graduate which qualify under the rules and have active engagement and interest in school health promotion.
Membership type
- Ordinary Organisation Member
- Ordinary Individual Member
Organisation
Mailing Address
Contact Person
Position
Phone
Mobile
Email*
Details of other delegates from agency/organisation
Name
Position
Email
Name
Position
Email
Name
Position
Email
All members can have their programs on the WAHPSA website. Do you wish to be listed in the directory?
- Yes
- No
Please complete the Member Information form below so that your information can be added to the website.
Payment details
- Cheque is to be made payable to WA Health Promoting Schools Association. Post to: Sally Blane, Treasurer, WAHPSA, c/- Cancer Council WA, Level 1, 420 Bagot Road, Subiaco WA 6008
- Please issue a tax invoice.
- Credit card. Contact WAHPSA on (08) 9388 4351 with details. Credit card surcharges apply.
- I would like to pay $80 for a one year membership (organisations only)
- I would like to $150 for a two year membership (organisations only)
- I would like to pay $30 for a one year membership (individuals only)
- I would like to pay $50 for a two year membership (individuals only)
Email invoice to:
Select Membership
- Associate Member No charge
(i) Schools: including government, independent and catholic schools (ii) Individuals: including university students and school staff and Honorary Members No membership fee. Associate Members are not entitled to vote at meetings of the Association.
Membership type
- Schools
- Individuals (includes university students and school staff)
School (if applicable)
Mailing Address
Contact Person
Position
Phone
Mobile
Email
Agency Information
Name of Agency
Agency Website
Contact Person
Position
Contact Email*
Select Number of Programs
Program Details – Program 1
Program Name
Contact Phone Number
Contact Email
Website
Brief Description
Health Area (s)
- Food & nutrition
- Health & safety
- Health conditions
- Mental health wellbeing
- Physical activity
- Professional support
Program Details – Program 2
Program Name
Contact Phone Number
Contact Email
Website
Brief Description
Health Area (s)
- Food & nutrition
- Health & safety
- Health conditions
- Mental health wellbeing
- Physical activity
- Professional support
Program Details – Program 3
Program Name
Contact Phone Number
Contact Email
Website
Brief Description
Health Area (s)
- Food & nutrition
- Health & safety
- Health conditions
- Mental health wellbeing
- Physical activity
- Professional support
In addition to this form, please supply high resolution images of:
>>agency logo (e.g. Cancer Council WA)
>>program logo(s) (e.g. SunSmart)
Select Files
Drop files here or

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Membership Program Information

WA Health Promoting Schools Association Inc. Membership Application

Details of other delegates from agency/organisation

Agency Information

Program Details – Program 1

Program Details – Program 2

Program Details – Program 3

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