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Women With Disabilities Australia (WWDA)
Membership (full)
Membership (full)
Membership (full) (1)
Contact details
These questions are about who you are and how best to contact you
Name
(Required)
First
Last
Email
Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Date of birth
(Required)
MM slash DD slash YYYY
About you
These questions help WWDA understand the experiences of our community and strengthen our advocacy. We know that language can sometimes feel limited, and the answer options may not fully capture your experience. Please choose the responses that feel most right for you. WWDA values the diversity of our community, and we want everyone filling out this form to feel respected, recognised and included. Your information will be kept confidential.
Do you confirm that you identify with the one or more of the following: woman, non-binary, feminine-identifying?
(Required)
Yes
No
This wording reflects who is eligible to be a full member under our Constitution. As an organisation we represent women, girls and gender-diverse people with disability.
Are you someone with trans or gender-diverse experience (meaning your gender identity may not align with your sex assigned at birth)?
(Required)
Yes
No
Prefer not to say
Do you identify as being part of the LGBTQIA+SB community?
(Required)
Yes
No
Prefer not to say
Do you identify as being Aboriginal and/or Torres Strait Islander?
(Required)
Yes I identify as Aboriginal
Yes, I identify as Torres Strait Islander
Yes, I identify as Aboriginal and Torres Strait Islander
No, I do not identify as Aboriginal or Torres Strait Islander
Prefer not to say
Do you come from a culturally and linguistically diverse background?
(Required)
Yes
No
Prefer not to say
Do you come from a migrant or refugee background?
(Required)
Yes
No
Prefer not to say
Which disability communities do you identify with? (please select all that apply to you)
(Required)
Neurodivergent community (for example: Autism, ADHD, Tourette syndrome)
Intellectual disability community (for example: Down syndrome, Fragile X syndrome, Prader-Willi syndrome, foetal alcohol spectrum disorder)
Acquired/traumatic brain injury community (for example: brain injury due to accident, stroke, illness, violence or other trauma)
Dementia community (for example: Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia)
Psychosocial disability community (for example: mental health condition/s, mental health service users))
Neurodegenerative disability community (for example: multiple sclerosis, motor neurone disease, Parkinson’s disease, Huntington’s disease)
Physical disability community (for example: cerebral palsy, spinal cord injury, muscular dystrophy, limb or facial difference, amputation)
Blind or low-vision community
Deaf or hard of hearing community
Not listed here
If not listed, please describe which disability community you identify with or what disability/s you have
Do you live with one or more chronic health conditions
(Required)
Yes
No
Prefer not to say
Are you a participant in one or more of the following:
(Required)
NDIS
Aged Care
Disability Support Pension (DSP)
None of the above
Not listed here
Prefer not to say
Do you agree to WWDA contacting you about your experiences to support our advocacy work?
(Required)
Yes
No
Membership declaration
WWDA understands that some members may complete this form themselves, while others may do so with assistance from a carer, support person or trusted representative. Both approaches are recognised and accepted.
Membership requirements
(Required)
I understand the conditions of WWDA’s membership requirements. *
Eligibility
(Required)
I confirm that I am eligible to join WWDA. *
Privacy Policy
(Required)
I agree to WWDA’s privacy policy *
Link to privacy policy: https://wwda.org.au/privacy-policy/
Membership Register
(Required)
I consent to my name and membership details being included on WWDA’s membership register. *
Mission and values
(Required)
I confirm that I align with the mission and values of WWDA, agree to abide by the constitution, and wish to join as a Full Member.
I consent to receiving direct marketing communications and information from WWDA.
(Required)
I consent
I do not consent
Your information will only be used by WWDA to manage your membership and related communications, and will be handled in line with our privacy obligations.
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Women With Disabilities Australia (WWDA) acknowledges the Palawa of Lutruwita, whose unceded land is where this website was created.
We invite you to acknowledge, reflect and seek to learn about the First Nations Country you are joining from today.
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