Membership Checkout - WA Occupational Therapy Association

Membership Information

You have selected the Non Working membership level.

(Standard rate after 20/1/25 - $435)

Early bird (sign up before 20/01/2025)

The earlybird code has been applied to your order.

The price for membership is $355.00 now.

Membership expires on January 1, 2026.

Account Information

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Personal Information

I wish to apply for membership of WA Occupational Therapy Association (Inc) and I agree to accept and abide by the ethics and constitution.

Title

First Name

Surname

Previous Name (if applicable)

Year of Birth

Postal Address

Suburb

Home Phone

Mobile Phone

Work Details

Work Details - Organisation

Department

Address

Suburb

Phone

Mobile

Expertise

Current Local Interest Group Membership

Qualifications

OT Registration Board No. / National Registration Board No.

Original Date of Registration

Qualification type

Date of Qualification

Institution

Billing Address

First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country