Membership Form 2021
Membership Application Form for Pride Society of UTAS 18 years and over only

Membership Pricing:
UTAS Student - $10
Associate (Non-student) - $20

Upon completion of this membership form, payment should be expected within 3 days unless an extension is requested, all payments are to be via bank transfer into the Pride Society account -

Pride Society of UTAS
Bendigo Bank
BSB - 633-000
Account Number - 181801242
Pls use ur name as the message so we can easily identify your payment

As a member of the Pride Society, it is expected that you care for and respect all members equally.
Membership is open to everyone, the society is designed as a safe space for every person and it is expected that our members attempt to assist in providing such a space to all other members.
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Pronouns
Your name as registered with UTAS (If different from your chosen name)
Your Name *
Surname *
Date of Birth (18 years and over) *
MM
/
DD
/
YYYY
Email *
Phone number *
UTAS Student (S) Associate (A) *
UTAS ID Number (If Applicable)
Campus
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Membership Type
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Domestic (D) International (I)
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Year of Study (If Applicable)
Course (If Applicable)
Can we share or post images of you at events on social media? *
Paid (Office use only)
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