Membership/Associate Application Form - Individual Representative

Western Victoria Primary Health Network Limited

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I wish to apply for Membership/Associate of Western Victoria Primary Health Network Limited. I understand that the Organisation is governed by a Constitution and that Membership/Associate is free. I understand the implications of being a Company Member/Associate as described in the Constitution, and undertake to inform the Company if my Member/Associate eligibility criteria changes. I am committed to working in an integrated primary care system in the Western Victoria region.

To view the constitution please click here.

Membership Category

Associate Category (Non-Member Stakeholder)

Please note: All Applications for Membership/Associate must be considered by the Board of Directors. If your application is successful, you will be advised the outcome following the relevant Board meeting.