The Foundation offers a choice of ways to apply for or renew your membership:
a) Using our online application form and PayPal to pay the membership fee 1
b) Downloading and posting an application form with a cheque or money order
c) Downloading and posting/faxing an application form with credit card details.
1 Unfortunately it is not possible to use the online form with a cheque or money order
Online Application
Offline Application
Please download one of the following membership forms:
Instructions for submitting the form and for payment are provided within each form.
General Instructions
All information is confidential, and will not be divulged without your express permission. The information will allow us to conduct statistical surveys, maintain consistent records within our organisation, and enable mail-outs of newsletters, notices, contact lists and information to our members. At any time you may request the APF to provide details of any information collected and/or stored, and also request the amendment or removal of any health information collected and/or stored on your behalf.
Applicant / Patient details:
Please provide the patient’s name if the patient is a different person to the person applying for membership. Membership will be recorded under the name of the applicant on our database, and newsletters / mail-outs will be sent to the applicant’s address. This is particularly import in respect to a parent being the applicant and the child being the patient, or the applicant being a carer.
Pituitary Conditions of the Patient / Treatments for the Pituitary Conditions:
Pituitary gland disorders can arise from many different causes, and therefore have varying unique effects on the body and mind. The APF attempts to meet the needs of these many different conditions. In this section of the form we ask you what the patient’s original condition was (primary cause of pituitary disease), and also what their current condition is so that we can provide for your specific needs. It also helps to get statistics on the number of patients with the various conditions so that we can supply all our members with the information they require, and avoid neglecting any less common pituitary disorders.
Please give us the full name/s of your condition if it is not already on the list:
You may tick only one original condition, but may tick more than one current condition, as a few of the conditions could occur at the same time, or at different times in a patient’s life (eg. Hypopituitarism and Growth Hormone Deficiency; Diabetes Insipidus after treatment of a pituitary tumour).
Phone & Email Patient Contact Register:
By electing to go onto the Contact Register you are inviting other patients and family / carer members of the Foundation to contact you for a chat (either by phone or email - you choose). This service is only available to other patient and family / carer members. To ensure member privacy, it is not available to non-financial members, health professionals or other external parties.
Payment
All memberships are $30.00 AUD and are due for renewal at the end of the financial year (30th June). Applications received after 31 March are entitled to membership until June of the following year. In cases of genuine financial hardship, this fee may be waived - please contact the Treasurer.
Cheques / money orders should be made payable to the:
Australian Pituitary Foundation Ltd
Please do not forward cash in the mail.
We can now accept credit card (mastercard and visa only) by phone or written permission via your faxed or posted membership form - if you wish to pay with your credit card online we can only accept PayPal as your method of payment.
Payment for online applications and renewals is by PayPal.
Membership is not tax deductible.
Donations of $2.00 or more are tax deductible.
Please contact the Treasurer if you have any further queries;
Sue Kozij
Ph: (07) 3376 2083