Expression of Interest form
To apply for ARIA membership, please complete the following form.

The ARIA Steering Committee meet monthly to discuss new membership; you will receive a response after Steering Committee review.
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Background
The Australian Regional Immunisation Alliance (ARIA) brings together Australian immunisation and vaccine preventable diseases (VPD) experts from at least 12 organisations, with decades of experience in Australia and the Asia-Pacific region. ARIA works with governments, global immunisation partners, non-government organisations and other partners to strengthen immunisation and reduce the impact of VPDs in the region.

Eligibility for membership
1. Australian-based or formally linked to an Australian institution; and
2. Recognised for their regional and/or international experience and expertise related to immunisation and VPD relevant to ARIA objectives
3. Signatory to the ARIA membership code; and
4. Committed to supporting the ARIA guidelines

Title
Full name
Primary affiliation/organisation
Secondary or other affiliation(s)/organisation(s)
Role/other titles
Years of experience in sector
Number of years post-PhD/MPH or other, if applicable
City where you are predominately based
Address
Email
Phone number/s
How did you hear about ARIA? Tick all that apply:
Please provide a brief professional biography, outlining your experience in relation to immunisation and vaccine preventable diseases, within Australia only.  This could include involvement with relevant committees, funding sources, nature of projects you are currently engaged in etc. NB: A section for regional/international experience can be found below. Word limit: 200 words. PLEASE NOTE: The General Information and Professional Experience biography you provide will be made available on the ARIA website. The exception to this is individual (direct) phone numbers and email addresses, which is for internal ARIA Secretariat use only.
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