Retired Membership Application - Academy of Child & Adolescent Health

Retired Membership

Category includes:

- A current or former Member who has completely retired from active clinical practice; or
- a retired Fellow of the RACP or equivalent who held accreditation to practise as a paediatrician in Australia or New Zealand.
- a retired health professional who practiced in the field of child and/or adolescent health or research within a health care institution, accepted by the membership committee.

Price:

$100

First Name:* First Name Required

Last Name:* Last Name Required

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City:* City is Required

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Which health profession best describes you:* Which health profession best describes you is Required

If you selected 'other' in the above profession, please enter your health profession in the textbox below: If you selected 'other' in the above profession, please enter your health profession in the textbox below is not valid

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I have read and agree to* (documents linked below):* I have read and agree to* (documents linked below) is Required

Terms and Conditions ACAH Constitution Code of Conduct

Please provide a brief summary on why you are interested in joining the Academy?:* Please provide a brief summary on why you are interested in joining the Academy? is Required

Are you of Aboriginal and/or Torres Strait Islander origin?:* Are you of Aboriginal and/or Torres Strait Islander origin? is Required

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Description	Amount
Retired Membership – Payment	$100.00
Total	$100.00

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ACAH Constitution

Members agree to be bound by the terms of the governing constitution.

ACAH Code of Conduct

Members agree to be bound by the terms of the Code of Conduct.

Terms and Conditions

Membership of the Academy of Child and Adolescent Health is available upon completion of the relevant membership form and payment of the requisite membership fee.

By continuing with your application for new membership you confirm that you:

- have read the constitution of the Academy of Child and Adolescent Health dated december 2016 and agree to be bound by the constitution and the ACAH code of conduct
- understand that acah is a not-for-profit company limited by guarantee and that your guarantee is limited to twenty dollars (aud $20.00).
- certify that you meet the eligibility criteria for the membership category applied for on this form and that i will immediately advise acah of any change in eligibility.
- authorise your name to be placed in the register of members.

Cancellation of Membership

Membership may be cancelled at any time by contacting admin@acah.org.au.

BUILT BY

The Academy of Child and Adolescent Health acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respect to their Elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.