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Application for Membership Form

I declare that I am eligible for membership of the Gulf Region Aboriginal Corporation RNTBC.

My Primary Affiliation is to: *Lardil PeopleYangkaal PeopleGangalidda PeopleKaiadilt People

and my Secondary Affiliation is to: *Lardil PeopleYangkaal PeopleGangalidda PeopleKaiadilt PeopleNo Secondary Affiliation

First or Given Name: *

Surname: *

Date of Birth: *

Place of Birth: *

Residential Address

Address: *

Suburb/City: *

State: *

Postcode: *

Different Postal Address?

Postal Address

Postal Address: *

Suburb/City: *

State: *

Postcode: *

Mobile: *

Email: *

I understand that rule 8.10 of the GRAC Constitution provides that the Board of Directors may seek further information relevant to the membership eligibility criteria to assist in the determination of my application for membership.

I consent to such information being sought.

Please do not fill in this field.

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If you need help filling out a form or have questions, please reach out. We’re here to support our community, especially Elders and those who may need assistance.

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contact@gracpbc.com.au

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EMAIL

contact@gracpbc.com.au

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ADDRESS

Lot 2, Old Mission Road
Gununa, Queensland, 4892

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