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Application for Membership
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Type of Membership
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A Past Trainee is someone who completed their training at the Ballarat Base Hospital. An Associate member is someone who has worked at the hospital for at least 12 months.
Past Trainee of Ballarat Base Hospital
Associate Member
Given Names
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Your answer
Surname
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Your answer
Maiden Name
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Your answer
Year Commenced Training
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Your answer
Number / Street Address
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Your answer
Suburb/City
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Your answer
Postcode
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Your answer
Your Email Address
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Your answer
First Proposer Name - Must be member of League
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Your answer
First Proposer Phone Number
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Your answer
Seconder Proposer Name - Must be member of League
Your answer
Seconder Phone Number
Your answer
In the event of my admission as a member to the League, I agree to abide by the rules of the League.
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Yes
Payment $10 (one off payment)
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Bank Transfer - BBH Trained Nurses League, BSB 063 556 10055976, use surname & initials as your ID.
PayPal - click "Pay Now" at top of page.
Cash
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