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Assyrian Cultural & Social Youth Association Inc. Membership Application
The Assyrian Cultural & Social Youth Association Inc. (ACSYA) is powered by an incredible network of dynamic and creative people from all walks of life. If you believe in our values, then you should become an official member.
Applicant Details
Full Name
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Residential/ Mailing Address
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Date of Birth
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Place of Birth
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Contact No (Landline or Mobile)
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E-mail Address
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Qualifications/ Certifications
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Interests/ Hobbies
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Language(s) spoken (Other than English)
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Emergency Contact
Full Name
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Residential/ Mailing Address
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Contact No (Landline or Mobile)
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E-mail Address
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Relationship with Applicant
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Terms & Conditions
The following terms and conditions apply to all individual applicants seeking membership
with the Assyrian Cultural & Social Youth Association Inc. (ACSYA).

1. I consent to becoming a member of the Assyrian Cultural & Social Youth Association Inc. (ACSYA).
2. I agree to support the objectives and purposes of the organisation as follows:
A. To promote the aims of ACSYA and support the organisation in achieving their goals.
B. To foster a membership of committed volunteers who act on the basis of goodfaith, giving shape to and hope for our future.
C. To practice the ACSYA Constitution, Anti-Discrimination Bullying and Harassment Policy, and Code of Conduct on the basis of goodwill.
3. I understand that my contact details may be shared with other divisions of the organisation.
4. I hereby grant ACSYA royalty-free worldwide license to use any of my work I generate in my capacity as a member to promote, publish, broadcast, distribute, and import that work in all fields. Such license includes, without limitation, the right to distribute, and create derivative works from any copyrighted materials, to which I own the copyright. Furthermore, I authorise ACSYA to make use of audio/ visual content (including and not limited to photographs, digital images, drawings, renderings, audio and visual recordings) of myself. I hereby release ACSYA from any claims, damages, or liability which may arise.
5. I understand through collaboration as a volunteer and or member of ACSYA, I may learn of, develop and/or receive sensitive information where confidentiality is required. Information including and is not limited to presentations, printed documents, loose notes, diaries, drawings, photographs, electronically shared information, meeting minutes, computer screen shots and print outs. I understand that the unauthorised use or disclosure of confidential information is a serious breach and agree not to do so unless required to by law.

I have read the terms and conditions of this application and agree to the terms set forth.

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