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Name

Email

Postal Address

Membership Type Individual

Organisation

I prefer to be communicated with by email

I apply for individual membership of the Foundation - please invoice me for $50 for the current financial year

My organisation applies for corporate membership of the Foundation - please invoice us for $200 for the current financial year

Please contact us about a reduced fee as we are a charitable organisation

I am interested in Foundation (Life) Membership 500 individual

$2000 corporate

Please contact me on the phone number below: (include area code):

My areas of human rights interest are: (refer to the Areas of Interest in the About Us Section)

I would be interested in being part of an Interest Group

I am interested in being on the Management Committee

I agree to other members and supporters of the Foundation being made aware of my interest in the Foundation

Membership Application Form