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Emerge Australia Membership

Please fill in the following details to renew your membership or become a member. We offer annual pricing options of $5 for people experiencing financial hardship, no evidence is required, or $50 full membership. You can select the option suitable for you at the bottom of this form.

Please note this is an application form for membership - if for any reason you are not eligible for membership we will inform you directly and provide a refund of your membership fee. 

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I am
Contact Information
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First Name
Last Name
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Address Line 1
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