Registered Office
1 Feathertop Ave, Lower Templestowe, Vic
Ph: (03) 9852 1945
Toll-free: 1300 797 842
Email: headoffice@pwpvic.com

 

Join PWP Victoria and reap the benefits... ONLY $58au

Please complete all sections marked on our membership form. Once the form is filled out you will be taken to a secure server through Paypal where you may pay via credit card or via your Paypal account if you have one.

If you have questions regarding us check out our FAQ page or phone 1300 PWP VIC

Membership Type
* * * 12 Months membership* * *


ALL QUESTIONS IN RED MUST BE COMPLETED
 PWP Member
• Access to members only website
• Bi-monthly Solo magazine
• Attend any branch functions
• Meet single parents
• Welfare help and advice

Payment System

PLEASE MAKE SURE YOU SELECT A PAYMENT TYPE

Credit Card Please make a selection. Ple
Your First & Last Name
Must match the name on
your credit card account
A value is required.First Name
 A value is required.
Last Name
100% Secure
 
How did you hear about us?
If you would like to join a particular branch please list below:
Please select an item.
Your E-Mail Address
A confirmation email will be sent
to you at this address
 A value is required.Invalid format.
We will never sell or disclose your email address to anyone.
Residential Details
Details where you live
 A value is required.
Sreet No., Street, Suburb, State
Postal Address
Postal address if different

Street No., Street, Suburb, State
Your Date of Birth
Enter dd/mm/yyyy
 A value is required.
Male / Female
Please choose
 Female Male Please make a selection.
Your Occupation
 A value is required.
Your Contact Phone Number
This can be either home phone or mobile number.
 A value is required.
Your Marital Staus
You MUST be a parent to join PWP.
 Widowed Divorced Separated Never Married Please make a selection.
How Long in this Situation
 A value is required.
Pensioner Type
Enter the type of pension benefit if applicable (eg: single parent pension).
Hobbies / Interests
Let us know if you have any hobbies or special skills..
Next Of Kin Details
In case of emergency.
 A value is required.
Full Name		 A value is required.
Contact Number
Next Of Kin Address Details
Working With Children Card
If you have a card enter card no. and expiry date

 Yes No Please make a selection.
Card Licence No. (if applicable)
Card Expiry Date (if applicable)
Obtaining a Working With Children's Card
Do you consent to obtaining a card if neccessary.
 Yes No Please make a selection.
Bi-Monthly Magazine 'Solo'
How would you like your Solo magazine delivered.
 Electronically via Internet / Email Postage Please make a selection.
Your Photograph
Do you consent for your photo taken at functions to be used in our publications..
 Yes I consent No I do not consent Please make a selection.
Your Child's Photograph
Do you consent for your child's photo taken at functions to be used in our publications.
 Yes I consent No I do not consent Please make a selection.
Identification
Please enter a form of identification (eg: drivers licence} This must be produced upon request at an introduction night
 A value is required.
Identification Type Number
Enter your identification number from your ID type above
 A value is required.
Your Children
Please fill in details of all your children regardless of custody.
 
Last Name 
First name
DOB
Custody 
Male / Female
Child1  A value is required. A value is required.
A value is required.
A value is required.
 A value is required.
Child 2
Child 3
Child 4
Child 5
Child 6
           
Children's Other Parent
Are the children's other parent a current member of PWP Victoria
 Yes they are a member No they are not a member Please make a selection.
Ex Partners Name
The name of your ex partner if known or applicable
Ex Partners DOB
TheDOB of your ex partner if known or applicable
Ex Partners Address
The address of your ex partner if known or applicable

I the undersigned do solemnly and sincerely declare that I AM A SINGLE PARENT, and the attached form and details are true to the best of my knowledge and belief. If it is found that I have deliberately given misleading information I can have my membership cancelled. I will abide by the rules and regulations of this Organization, the Constitution, By Laws, Preamble and Code of Conduct, knowing if I don’t I can be suspended.
You MUST agree to these statements in order to join Parents without partners Victoria
By accepting this you agree to the above: Please make a selection.

All your information will be handled Discreetly and Confidentially.

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