Membership Form

Organisation/Group/Company/Individual Name: *

Postal Address: *

Physical Address: *

Contact Number *

Fax Number:

Email address: *

Website (if any):

Name of Contact Person in Organisation: *

First

Last

Position of Contact Person: *

Email address of Contact Person *

Phone number of Contact Person *

Membership Type: *

Full Membership.
Associate Membership
Life Membership
Corporate Membership

a) FULL MEMBERSHIP: This is open to any organisation that: • Supports the policy and objectives of the PDF; • Has a genuine interest in disability-related concerns in the Pacific region; • Is located or substantially operates in the Pacific region (the member may also operate substantially in other regions); • Satisfies the general qualifications for membership, and • Is a non-government organisation, and • Is an organisation of and for people with disabilities with a governing body comprised of a majority of persons with disabilities, and • Is operating within a Pacific country; • Represents women with disabilities in the Pacific that is the governing body of the organisation must be comprised of a majority of women with disabilities. • Represents young persons with disabilities in the Pacific that is the governing body of the organisation must be comprised of a majority of young persons with disabilities under the age of 25. • Is an organisation of indigenous persons with disabilities that is the governing body must be comprised of a majority of indigenous persons with disabilities. (b) ASSOSCIATE MEMBERSHIP: Associate membership of the PDF is open to any individual or organisation that: • Supports the policy and objectives of the PDF; • Has a genuine interest in disability-related concerns in the Pacific region; • Is located or substantially operates in the Pacific region (the member may also operate substantially in other regions); • Satisfies the general qualifications for membership, and • Does not satisfy the qualifications for full membership, • Is an organisation of family members and carers of persons with disabilities, that is, the governing body must be comprised of a majority of family members and carers of persons with disabilities. • Is an international disability organisation recognised and active in the Pacific region through regional or sub regional activities. (c) LIFE MEMBERSHIP: Life membership may be awarded by the General Forum on the recommendation of the Board to an individual who has made an outstanding contribution towards the fulfillment of the policy, purpose and objectives of the PDF. (d) CORPORATE MEMBER: Corporate membership of the PDF is open to any business entity, multinational company or groups that: • Satisfy the general qualification for membership; and • Wish to make a financial investment or contribution towards the fulfillment of the policy, purpose and objectives of the PDF.

Description of Organisation

Briefly describe the applicant’s programmes or activities:

Supporting Statement:

Give a brief supporting statement that sets out how the applicant individual or organisation satisfies the qualifications for membership in respect of the category in which membership is sought. (attach other pages if required)

Declaration:

Agree

By placing a tick in this box affirms that the applicant has read the Constitution of PDF and considers that the applicant is in compliance with the vision, objects, and principles of PDF.

Membership Form

The Pacific Disability Forum is supported by the Australian Government.

Locate Us

Ground Floor, Kadavu House, Victoria Parade, Suva, Fiji Islands.