Membership Application

APS Contact Information

Should you have any queries, please contact the Secretariat office at 02 9016 4343 or by email aps@apsoc.org.au
APS Secretariat
PO Box 637
North Sydney NSW 2059
Tel: 02 9016 4343 Fax: 02 9954 0666
Email: aps@apsoc.org.au

APS Online Membership Application Instructions

The Australian Pain Society is a fully constituted not-for-profit association of multidisciplinary professionals with a keen interest in the prevention and management of pain for all people across their lifespan.

As such, membership is not simply a matter of paying a fee to join.

Thank you for respecting the process below.

Step 1: Complete the online form below, noting the mandatory fields.

Step 2: After you submit the form the system will send a copy of the pre-filled membership application form to your primary email address. This form will include your temporary membership number.

Step 3: Please print the emailed application form and have it signed and dated by your proposer (a current member of the APS). If you do not have a proposer, please contact your local state/territory director (refer to the APS website 'Office Bearers' section for contact information).

Step 4: Sign and date the form yourself. (Steps 3 and 4 are requirements of the APS Constitution).

Step 5: Send the signed form to the APS Secretariat. Scanned emails are preferred but the form can also be returned by fax or post (per details above)

Step 6: After the APS Membership Committee has approved your application, you will be notified by email and requested to make payment accordingly.

Member Information

Title *
v
First Name *
Last Name *
Age Range *
v
Gender *
v
Post-nominal/Qualification *
Discipline *
v
Specific Area of Interest
v

Primary Contact
Company/Organisation/Institution
Please enter primary contact number or mobile number* (Please include area code)
Primary Contact Phone ( e.g. 03 9999 88xx )
Mobile ( e.g. 0413 999 xxx )
Email (Primary)*
Please enter Email (Primary) again *
Address Line 1
Address Line 2
Suburb
State
v
Post Code
Country
v
Work Contact
Tel. (Work)
Fax
Email (Work)
Website (Please include http:// or https:// in URL)
TeleHealth URL (Please include http:// or https:// in URL)
  Click here if the address is the same as Primary Contact.
Address Line 1
Address Line 2
Suburb
State
v
Post Code
Country
v
Home Contact
Tel. (Home)
Email (Home)
  Click here if the address is the same as Primary Contact.
Address Line 1
Address Line 2
Suburb
State
v
Post Code
Country
v
Opt-IN
 
Opt-IN for Listing (Only the details in 'Work Contact' will be displayed)
Checkboxes select listing perferences.
 
  I would like to be in the Private Membership Listing. Only APS members can look up my details.
  I would like to be in the Public Listing. This feature is available on the APS website.

Membership Type

Choose the correct tier based on your Pre-Tax Gross Income

Note: Pre-tax gross income is the annual income from all the sources, i.e. not only from pain related work.

If you select Student Membership, the following criteria must be met:

  • Proof of full time student status from educational institution to be provided; and
  • Annual income within specified limit, as per below

v

Special Interest Group

Please check the below box if you wish to join the Special Interest Group

APRA Donation

The Australian Pain Relief Association, an ATO registered charity, works closely with the APS to support PhD Scholarships, pain education and research. Donations over $2 are tax deductible.

Voluntary contribution amount

Payment Summary

Membership amount :
SIG total amount:
APRA Voluntary contribution amount (Over $2 is tax deductible) :

Total payment amount :


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