Northern Rivers Wildlife Carers Membership Form Annual Membership (valid 1st July to 30th June) Northern Rivers Wildlife Carers Inc., PO Box 6439, South Lismore 2480 After filling in the membership form, you will be redirected to make an online payment. Membership type NRWC covers the local government areas of Ballina, Byron, Kyogle, Lismore & Richmond Valley. If you reside outside these areas, you can join as an associate member. To be a wildlife carer with NRWC you need to be a minimum age of 18 years. Active Rescue & Care MembershipAssociate Support Membership Membership Details First Name (required) Last Name (required) Residential Address (required): Postal address (if different): Phone (required): Mobile: Email (required) Additional adult family members at the same address may receive membership for $10 per person. Please fill in a separate form for each additional member and submit all forms prior to completing the final payment. Member Name (2): Member Name (3): I would like to receive the newsletter by Email (colour electronic document)post (Black & white paper document) Membership Agreement I / We agree to abide by the licensing and other relevant requirements of the NSW Office of Environment & Heritage and the Constitution and Policies of Northern Rivers Wildlife Carers Inc. OEH Code of Practice NSW Wildlife Council Code of Ethics NRWC Carers Policy NRWC Constitution I accept (required): NRWC’s Management Committee has the right to refuse membership to any applicant or may refuse to renew any membership. In no case shall the Committee be required to give any reason for the rejection. Applications for membership will be put forward for ratification at the next Committee meeting and a receipt or authorisation will be issued after approval. Volunteering Full Name I would like to assist with: (Please tick appropriate boxes) Transporting / Rescuing*Rescuing / Caring*Phone rosterTransporting to Currumbin Wildlife HospitalConstruction of nest boxes / aviariesRelease siteFundraisingPublicity / MediaEducation & TrainingBat feedingData entryWebsiteAdministration Other (please specify): * If you are interested in transporting, rescuing or caring, may we contact you during: (Please tick appropriate boxes) DaytimeEveningNight emergency only e.g. an unfurred joey) Workplace (Town): Work days: Work Hours: Work Phone: May we call you at work (for rescue/transport after work)? YesNoN/A Future Training Please indicate which specialised training days you would be interested in attending: Possums & small marsupialsMacropodsBirdsReptilesBats / Flying-foxesEchidnas NRWC Membership Fees & Donations Membership fee ($20.00 for each adult member) Additional members ($10.00 for each additional adult member at the same address) Donation ($2.00 or more are tax deductible) You will be redirected to make an online payment after submitting the form. Please fill in a separate form for each additional member and submit all forms prior to completing the final payment. Enter code: Thank you for completing this form