BRONZE Organisation membership

Team members details

Please nominate two team members to receive the Individual Professional Membership

Team member 1

Name(Required)
Email Address(Required)
Home Address(Required)

Team member 2

Name(Required)
Email Address(Required)
Home Address(Required)

Upload images

Please upload the image(s) of your organisational logo. Use .jpg or .png formats only and if possible two different dimensions.
Drop files here or
Max. file size: 8 MB.

    Authorisation and consent to publish content

    By ticking the consent below, you authorise Palliative Care NSW to use the image provided on the Palliative Care NSW website and in our Annual Report only, to represent that your organisation is a current member of Palliative Care NSW. Thank you.
    Consent confirmation(Required)