2021 Membership
Membership is valid for the calendar year in which the membership form is completed.
Please note, in order for your membership to be processed, details must be completed in full.
First name *
Last name *
Email address *
Phone number *
Postal address (please include suburb and postcode) *
State/Country *
Date of Birth *
MM
/
DD
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YYYY
How do you describe your gender identity? *
We require this information for statistical reporting to our funders.
Do you identify as *
We require this information for statistical reporting to our funders.
Required
Do you identify as a person with a disability? *
We require this information for statistical reporting to our funders.
Do you come from a CALD (culturally and linguistically diverse) background? *
We require this information for statistical reporting to our funders.
Would you like to be added to our database of teachers? *
To acknowledge that the information you have provided is accurate and that you accept the terms of STRUT Dance Membership, please type your full name below, as an e-signature alternative. *
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