Congress M E M B E R S H I P

F O R M

How to apply for Congress Membership

Step 1

Complete the Application for Membership section on the other side of this fold.

Step 2

Tear off the Application for Membership section and place it into the Membership Box in reception at any of the Congress clinics listed on the next page.

OR post to: PO Box 1604, Alice Springs NT 0871

OR email to: membership@caac.org.au

Step 3

You will be notified about the outcome of your application after the next Board Meeting. The Congress Board meets every two months.

If you require help reading or completing this form, please contact the Congress on (08) 89514400.

Congress Contacts:

Gap Clinic Service P: (08) 8951 4444

Alukura Women’s Health Service P: (08) 8958 4800

Ingkintja Male Health Service P: (08) 8958 4567

Social & Emotional Wellbeing Service P: (08) 8959 4750

Child & Family Service P: (08) 8951 4444

Remote Health Services P: (08) 8951 4400

Sadadeen Clinic P: (08) 7999 6400

Larapinta Clinic P: (08) 7999 6450

Congress Membership Officer M: 0409 597 678

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Who we are

Congress has over 40 years’ experience providing comprehensive primary healthcare for Aboriginal people in Central Australia.

Our services

Our services target the social, emotional, cultural, and physical wellbeing of Aboriginal people. These services include:

Gap, Sadadeen & Larapinta Clinics providing a range of medical care for Aboriginal people living in those areas.

Alukura Women’s Health Service providing a wide range of medical services caring for women’s and baby’s health.

Ingkintja Male Health Service and a Men’s Shed providing care for men’s health and wellbeing.

Child & Family Service providing care for Aboriginal children and their families; helping children to develop and learn in the critical early years.

Social & Emotional Wellbeing Service providing care to improve the wellbeing of Aboriginal people of all ages.

Remote Health Services auspicing the delivery of health care services in nearby Aboriginal communities—Amoonguna, Santa Teresa, Ntaria, Utju and Mutitjulu.

Our members

Congress is an Aboriginal community controlled primary health care service. This means we rely on our members to keep us informed about the needs of our local Aboriginal community.

To be a member, you must be:

• Aboriginal

• 18 years of age or older

• A resident of Central Australia, having lived

in Central Australia for the two years prior to

applying for membership.

•

•

•

By being a member of Congress,

you can have a say in

the way we deliver our services

More information

For more information visit our website at: www.caac.org.au

You can also contact Congress on (08) 8951 4400 or email membership@caac.org.au

A P P L I C A T I O N F O R M E M B E R S H I P

I hereby apply to become a member of Central Australian Aboriginal Congress Aboriginal Corporation.

DATE:* DD / MM / YYYY

NAME:*

DATE OF BIRTH:* DD / MM / YYYY

PLACE OF BIRTH:*

RESIDENTIAL ADDRESS:*

SUBURB:*

Have you lived in Central Australia continuously for two (2) years prior to lodging for this membership?*

o YES o NO

POSTAL ADDRESS:*

SUBURB:*

EMAIL:

PHONE:

MOBILE:

We may wish to SMS you in the future. Is this okay?

o YES o NO

Preferred method of correspondence (please tick ONE): *

o POST o EMAIL

o Yes, I am an Aboriginal and/or Torres Strait Islander person w1and I am over the age of 18 years.*

o I agree to abide by the Congress Rule Book. For a copy of the w1For a copy of the Congress Rule Book, visit www.caac.org.au.*

o Yes, I want to be on the Congress mailing list in order to w1receive any Board Communiqués, special event notices etc.*

SIGNATURE:*

* Requires an answer

TEAR

OFF A

PP

LICA

TION

FOR

M A

ND

SUB

MIT

KEEP

THIS SEC

TION

FOR

FUTU

RE R

EFEREN

CE

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