Playgroup NSW Voting Member application
Full Name
*
First Name
Last Name
Playgroup Membership Number (If applicable)
*
Phone Number
*
-
Area Code
Phone Number
E-mail
*
example@example.com
Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Language and Cultural Diversity
In which country where you born?
*
Please Select
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic (CAR)
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic (Czechia)
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (formerly Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia (formerly Macedonia)
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Do you speak a language other than English at home?
*
Please Select
No, English only
Yes, please specify
Please specify
10. Are you Aboriginal or Torres Strait Islander? (For those who are Aboriginal and Torres Strait Islander Origin, please select both)
*
Please Select
No
Yes, Aboriginal
Yes, Torres Strait Islander
Playgroup History, Interest and Experience
Please share with us any experience or involvement you have had with Playgroup NSW or any other similar organisation to date
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Have you attended a Playgroup? If so, which one?
*
Do you volunteer at Playgroup? If so, in what capacity?
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Explain why you are interested in becoming a Playgroup NSW Voting Member
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List 3 topics or priorities you feel are relevant to Playgroup NSW and our provision of programs and services for families
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Do you understand, if approved to be a voting member, there are certain obligations you will need to adhere to, such as preparation for meetings, voting at the Annual General Meeting, attending other meetings as required, obtaining and keeping Working with Children Check and COVID-19 Vaccination in line with our policies and procedures and other responsibilities as appropriate from time to time
*
Please Select
Yes
No
Please provide details of any skills and experience that you would bring to your role as a Voting Member of Playgroup NSW
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Please list your involvement in other organisations, particularly (but not limited to) the not-for-profit, education, government and/or childrens services sectors
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Do you understand and accept there is an annual Membership fee of $85+gst to be paid on acceptance of your application and renewed on an annual basis for up to 3 years, the fee of which may be reviewed and changed over time, 3 months prior to expiry of the annual membership
*
Please Select
Yes
No
Submit
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