Application Form - Palliative Care Queensland Inc

Palliative Care Queensland Membership Form

Stay Informed | Get Involved | Support PCQ | Improve Palliative Care

Membership of Palliative Care Queensland is available to individuals or organisations who have an interest in palliative care, end-of-life care, or who share our vision of ‘quality care at the end of life for all Queenslanders’.
Have a question or require assistance with filling the form? Contact PCQ Team via email hello@palliativecareqld.org.au or ring 07 3842 3242

Email Address ^*

First Name ^*

Last Name ^*

Website

Address Details ^*

Postal Code

Country

Phone

Level

City

Organisation Type ^*

Sector ^*

Local Primary Health Network ^*

Please select “All” if the organisation cover statewide or nationwide. Please select “I don’t know” if unsure.

Local Hospital & Health Services ^*

Please select “All” if the organisation cover statewide or nationwide. Please select “I don’t know” if unsure.

How many employees does your organisation/company have? ^*

How many volunteers does your organisation/company have? ^*

How would you describe your organisation? (max 100 words)

This can be your company bio

Would you or your organisation be interested in volunteering for PCQ?

Yes

No

Maybe

Already a PCQ volunteer

Palliative Care Queensland is a Charity registered with the Australian Charities and Not-for-profits Commission. Would you or your organisation be interested in fundraising for PCQ?

How did you hear about PCQ? ^*

Facebook

LinkedIn

Twitter

ABN/ACN

Please specify department/service/project if applicable

Age Range

Company

Position

Professional Title

City

Local Government ^*

Please select “All” if the organisation cover statewide or nationwide. Please select “I don’t know” if unsure.

Company Name ^*

Type of Concession Card

Palliative Care Organisation you volunteer for

Your most recent profession

Type

State

Education - Tertiary Institution Name

Faculty

Does your organisation have a Reconciliation Action Plan?

Membership Plan

Membership Plans

I accept Palliative Care Queensland terms of use, terms of use and privacy policy.

Palliative Care Queensland

Individual membership includes:

Monthly e-News & regular members-only PCQ Matters e-Blasts with special briefings and insights (including information about our political engagement)
Free attendance of PCQ quarterly education mornings (Brisbane or Webinar)
10% discounts for PCQ hosted events
Ability to nominate to join the PCQ state council
Opportunity to apply to join PCQ Members Only Special Interest Groups

Organisational memberships includes:

Opportunities to be part of a collective voice for palliative care in Queensland
Annual National Palliative Care Week resource kit
Free opportunity to join up to three sites for the webinar education mornings
Opportunity to apply to join PCQ Members Only Special Interest Groups
Discounted rates on sponsorship/booths/tables for PCQ events
Regular PCQ e-News and PCQ Matters member-only e-Blasts to keep you abreast of current issues and trends with special briefings and insights (including information about our political engagement)
Opportunity to profile your organisation & promote employment opportunities in our PCQ E-News and social media pages
Promotion/ listing through the Palliative Care Queensland annual report
Ability to promote your PCQ Organisational membership via a certificate of membership and PCQ member logo

*Free Individual Membership for full time tertiary students, 50% off for Queensland volunteers and concession card holders.

Thank you for your interest in membership with Palliative Care Queensland

© Copyright 2024

Non Profit Software Powered by