Membership Registration
First Name
Last Name
Email
Phone Number
Company (if applicable)
Current Job Title
Membership Interest - Choose 1 or more
To be a Mentor
To be a Mentee
Networking Events
Professional Development
Profile Building
Career Advice
Advocacy
Speaking/Panel Opportunities
State Committee Member
Other (fill below short answer, if other)
Other Support wanted
Which State are you based?
Western Australia
Northern Territory
Queensland
New South Wales
Australian Capital Territory
Victoria
South Australia
Tasmania
International
Your postcode
Please advise if you are over or under 18 (WiDA holds some events at licensed venues)
17 years old or younger
18 years old and over
To help us better understand the diverse background of our members and improve our services, please provide your ethnicity. This information is optional, and you may select Prefer Not to Say.
Indigenous or Torres Strait Islander
Australian
African
American
Asian
British
Canadian
European
Middle Eastern
Other
Prefer not to say
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