P&C MeMBERSHIP FORM

2022

CONTACT DETAILS

Please note that your Membership is only valid for one year, or until the next AGM. If you wish to maintain your P&C Membership you will need to reapply each year.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

MEMBERSHIP INFORMAION

This Membership application is:

New

Renewal

I am:

I am a parent/caregiver of a student at Wishart State School

I am a community member over the age of 18 years

I am a Wishart State School staff member

DISCLAIMER AND SIGNATURE

I apply for membership in the Wishart State School Parents’ and Citizens’ Association and I undertake to:

(a) promote the interests of and facilitate the development and further improvement of the School and the good order and management of the School; and

(b) comply with the Constitution of the P&C Association, including the P&C Association Code of Conduct as specified in Schedule 2 of the Constitution, and any valid resolutions passed by the Association.

If a person has been convicted of an indictable offence, it is grounds for removal in accordance with the Education (General Provision) Act 2006.

I have read, understood and accept the conditions of this application

Name

First Name

Last Name

Date

Please note that this date is in AMERICAN format, so please put month first

YYYY