Membership* (required)
Community/Not for ProfitFor Profit/Government
SmallMediumLarge
Name of Organisation * (required)
ABN * (required)
Website * (required)
Address * (required)
Suburb * (required)
Postcode* (required)
Phone* (required)
Contact for operational/policy matters
First name* (required)
Last name* (required)
Position* (required)
Email* (required)
Contact for other correspondence
Briefly describe your organisation's activities.
Does your organization provide palliative care services? YesNo
Reason for joining PC ACT (can choose more than one) Access to information and resourcesOpportunity to influence and contribute to sectorSupport for PC ACT as a charitable organisationSupport for PC ACT to be a strong voice for palliative care in the ACTRaise profile and image of our organizationNetworking opportunitiesProfessional development
Direct Deposit (Bank Details will be emailed to you)I have sent my cheque made out to Palliative Care ACT to Tom Elvin Centre, 5 Flemington Rd, Lyneham ACT 2602.
My organization requires a Tax invoice before we can make payment
Home About us Find a palliative care service What is Palliative Care Organising Palliative Care Volunteers Contact us
Disclaimer Privacy Policy Sitemap Returns and Delivery
3 Flemington Rd, Lyneham ACT 2602
Become a volunteer Become a member Donate Contact us