Membership Sign-up or Renewal

1 Start 2 Payment 3 Complete

Membership Level

Membership Type *

Not-for profit/charitable organisations may be eligible for a 50% discount on membership fees if they are registered with the Australian Charities and Not-for-profits Commission. If this applies to your organisation, do not complete this form but instead contact us on (02) 9322 5197 for more information.

Key Contact

The Key Contact is the person responsible for managing the organisation's details and payment/renewals relating to the DCA membership. They will be the key contact for membership matters and may also be asked to participate in surveys on key diversity issues.

First Name *

Last Name *

Job Title *

Email *

Phone Number *

Same address as Organisation?

Use Organisation address

Street Address *

Street Address Line 2

Street Address Line 3

City *

State/Province *

Postal Code *

Country *

Organisation Membership

Please enter the details of the organisation this membership is for.

Organisation Name *

Industry sector *

Organisation operates

States/territories in which the organisation operates

Number of employees *

Member reason *

What is the main reason your organisation has decided to become a DCA member

Member reason, other

Other reason for becoming a member

How did you hear about DCA *

How did you hear about DCA?

Hear about DCA, other

Website *

Please enter the complete website address, eg. https://example.com.au

Phone Number

Special invoice instructions

Street Address

Street Address *

Street Address Line 2

Street Address Line 3

City *

State/Province *

Postal Code *

Country *

Billing Address

Billing Email *

Address

Address Line 2

Address Line 3

City

Postal Code

State

Country

CEO

Please enter details of your Organisation's Chief Executive (or equivalent)

First Name *

Last Name *

Email *

Street Address

City

State

Postal Code

Country

Terms and Conditions *

I accept the terms and conditions

Leave this field blank

© Diversity Council Australia 2017