UniMed Member Application Form

Our application form is now back online. You should be contacted within two weeks of your application. Please address any queries to info@unimed.org.au

* First Name

* Last Name

* Which of the following areas do you currently reside in (this will help us determine what UniMed networks you may be near)? PLEASE NOTE THAT CURRENTLY UNIMED ONLY OPERATES IN NEW SOUTH WALES. Applications from persons living outside of NSW will not be considered.[Click "?" for area boundaries]

* Address

* Suburb

* State

* PostCode

* Date of Birth (dd/mm/yyyy)

Email Address

Home Phone

Mobile

Other Phone

Occupation

Complete this section if you are studying currently.

At which institution are you studying?

What is your award and major? [Eg B.AppSci(Physiotherapy) or Dip Massage]

What year of your course are you in?

Qualifications

What qualifications do you currently hold?

* Do you have any other skills or qualifications which you think would be of value to UniMed?

Survey

What do you wish to gain from joining UniMed?

What areas of UniMed's activities most interest you?

* UniMed is interested in tailoring your volunteer experience to meet your personal needs. This helps make sure get the best experience. Use this space to make any comments which you think will help us.

Upon sumbitting this form you will be contacted by a UniMed manager to discuss you application and help you find the best opportunities in UniMed. Please note that active participation in UniMed is covered in NSW by the Child Protection (Prohibited Persons) Act 1999 and criminal record checks or child protection declarations may be required.

* Indicates Response Required

First Aid Certificate	Occupational First Aid
Sports Trainer Level 1	Sports Trainer Level 2
Enrolled Nurse	Registered Nurse
Ambulance Paramedic	Intensive Care Paramedic
Advanced Resuscitation	Automated External Defibrillation
Trainee/Intern Paramedic