Membership Information You have selected the Undergraduate Student Membership without MPPA membership level. The price for membership is $25.00 now. Membership expires after 1 Year. Account Information Username Password Show Password Confirm Password Email Address Confirm Email Address Full Name LEAVE THIS BLANK Already have an account? Log in here More Information ASPAH Membership Form Title Mr. Ms. Mrs. Dr. Prof. A/Prof. First Name Last Name Home/Postal Address Where we should send correspondence, including your copies of Medical Problems of Performing Artists Street 1 Street 2 City State/Province Select a State/Province Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Non-Australian State/Province Non-Australian State/Province Postcode Country Business Address This is the address we will use should you agree to be in our online directory of members (see below). You can leave these fields blank if you wish. Street 1 Street 2 City State/Province Select a State/Province Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Non-Australian State/Province Non-Australian State/Province Postcode Country Phone Numbers Please enter at least one contact phone number in the "Home" Phone field. The "Business" Phone field is the phone number we would publish if you choose to be listed in our online directory (see below). Home Business Phone Business Fax Mobile Your Email and Website Address Business Email Website Tell us a little bit about yourself... Gender Male Female Date of Birth Which of the Performing Arts are you most involved? Acting Singing Instrumental music performance Dance Circus perfomance Magic performance Spoken Performance (e.g: Comedy, Orotory, Poetry) Puppetry Musical Theatre Performance Please tell us which of the following categories best identifies you professionally or is most relevant to your membership with ASPAH. Capacity 1 Select a Capacity. Aboriginal and Torres Strait Islander Health Practitioner Acupuncturist Alexander Technique Teacher Ambulance Officer/Paramedic Association for Body Mapping Education Aromatherapist Art Therapist Audiologist Bowen Therapist Chinese Medicine Practitioner Chiropractor Dance Therapy Dental Practitioner Dietitian/Nutritionist Educator - Health Educator - Other Educator - Performing Arts Environmental health officer Exercise Physiologist Health care professional Homeopath Human Factors/ Ergonomics Instrument Repairer/ Modifier Kinesiotherapist Massage Therapist Medical Practitioner - GP Medical Practitioner - Other Medical Practitioner - Specialist Medical Radiation Practitioner Midwife Musculoskeletal Therapist Music Therapist Naturopath/Herbal Medicine Practitioner Nurse Occupational Therapist Optometrist Osteopath Performing Artist as Primary Occupation Performing Artist as Secondary Occupation Performing Arts Logistics and Support Performing Arts Management Pharmacist Physiotherapist Pilates Instructor Podiatrist Psychologist Psychotherapist Public Health Practitioner Recreational Therapist Rehabilitation Counsellor Reiki Therapist Researcher - Health Researcher - Other Researcher - Performing Arts Social Worker Speech Pathologist Student - Health Student - Other Student - Performing Arts Teacher / Educator Technical, management & support personnel Yoga Instructor Capacity 2 Select another one? Aboriginal and Torres Strait Islander Health Practitioner Acupuncturist Alexander Technique Teacher Ambulance Officer/Paramedic Association for Body Mapping Education Aromatherapist Art Therapist Audiologist Bowen Therapist Chinese Medicine Practitioner Chiropractor Dance Therapy Dental Practitioner Dietitian/Nutritionist Educator - Health Educator - Other Educator - Performing Arts Environmental health officer Exercise Physiologist Health care professional Homeopath Human Factors/ Ergonomics Instrument Repairer/ Modifier Kinesiotherapist Massage Therapist Medical Practitioner - GP Medical Practitioner - Other Medical Practitioner - Specialist Medical Radiation Practitioner Midwife Musculoskeletal Therapist Music Therapist Naturopath/Herbal Medicine Practitioner Nurse Occupational Therapist Optometrist Osteopath Performing Artist as Primary Occupation Performing Artist as Secondary Occupation Performing Arts Logistics and Support Performing Arts Management Pharmacist Physiotherapist Pilates Instructor Podiatrist Psychologist Psychotherapist Public Health Practitioner Recreational Therapist Rehabilitation Counsellor Reiki Therapist Researcher - Health Researcher - Other Researcher - Performing Arts Social Worker Speech Pathologist Student - Health Student - Other Student - Performing Arts Teacher / Educator Technical, management & support personnel Yoga Instructor Capacity 3 Select another one? Aboriginal and Torres Strait Islander Health Practitioner Acupuncturist Alexander Technique Teacher Ambulance Officer/Paramedic Association for Body Mapping Education Aromatherapist Art Therapist Audiologist Bowen Therapist Chinese Medicine Practitioner Chiropractor Dance Therapy Dental Practitioner Dietitian/Nutritionist Educator - Health Educator - Other Educator - Performing Arts Environmental health officer Exercise Physiologist Health care professional Homeopath Human Factors/ Ergonomics Instrument Repairer/ Modifier Kinesiotherapist Massage Therapist Medical Practitioner - GP Medical Practitioner - Other Medical Practitioner - Specialist Medical Radiation Practitioner Midwife Musculoskeletal Therapist Music Therapist Naturopath/Herbal Medicine Practitioner Nurse Occupational Therapist Optometrist Osteopath Performing Artist as Primary Occupation Performing Artist as Secondary Occupation Performing Arts Logistics and Support Performing Arts Management Pharmacist Physiotherapist Pilates Instructor Podiatrist Psychologist Psychotherapist Public Health Practitioner Recreational Therapist Rehabilitation Counsellor Reiki Therapist Researcher - Health Researcher - Other Researcher - Performing Arts Social Worker Speech Pathologist Student - Health Student - Other Student - Performing Arts Teacher / Educator Technical, management & support personnel Yoga Instructor Category Select a category. Health care professional Performing artist / student Teacher / Educator / Researcher Technical, management & support personnel Briefly describe your qualifications, experiences and any services you offer performing artists. This is especially important if you wish to be included in our Directory of Members. Brief Description If you are seeking the concessional rate please list your concession type (Pensioner Concession, Full Time Student etc) and the expiry date of your concession card here. Concession Type Why are you interested in joining ASPAH and what are you hoping an ASPAH membership can provide for you? Interest Would you like to be included in ASPAH's Online Directory of Members? If you are someone who is already helping performing artists, or are in a position to do so, ASPAH would like to have your permission to publish some of your details on this site as part of a searchable database. This would allow people visiting the site to search for someone they can ask for help. The fields we would publish are your Name, Business Address, Business Phone, Email, Website and the description of qualifications and services you listed in the question above. Tick this box to be included in our directory I consent to my details, other than my name, being available to other members who request to inspect the register of members* Affiliation If you are a member of an affiliated organisation could you please identify which one. PAMA members are entitled to Concession membership with ASPAH, you can select this option below. Affiliate Organisation None Performing Arts Medicine Association How did you hear about ASPAH? Past member Facebook Twitter Linkedin ASPAH website ASPAH Symposium/Conference Regional ASPAH Event- MPPA Journal Word of mouth Other [Please mention below] Source Type *The right of ASPAH members to inspect the society's Register of Members is legislated under the New South Wales Associations Incorporation Act, 2009, but members have the right to limit what is visible to just their name. Opt-In Mailing List Join our mailing list. ASPAH Newsletter Would you like to set up automatic renewals? Yes, renew at $25.00 per Year. Processing...
