Membership Form Name Address Occupation Phone Number Email Address Nominated By Would you like to receive news and updates from Advocacy WA? Yes, I would like to receive a news and updates on news, functions and activities of AWANo, I don't want an update If the above applies, please send my updates via: MailEmailSMS Would you be interested in becoming involved in any projects run by Advocacy WA? Yes, I would be interestedNo, I would not be interested By completing and submitting this form, I agree to be bound by the rules of Advocacy WA