University Club UWA Postgraduate Membership Application

Postgraduate Membership is available only to CURRENT postgraduate students of UWA. Confirmation of current enrolment in UWA Postgraduate studies must be proven in order to be eligible for Postgraduate Membership. This category of membership is fixed term to expire 12 months after you join. You will be contacted at the start of the month you are due to expire in and if we do not hear back from you the membership will be automatically cancelled on the last day of that month. Please complete this application form allowing 2 business days to process. The University Club respects your privacy and all information provided by you will remain confidential.

• Applicant Details

• UWA Student Number
• Title
• First Name*
• Surname*
• Preferred Name*
• Address*
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country
• Email*
• Primary phone number*
• Date of Birth*
  DD slash MM slash YYYY

• Club Account Request

• Members with valid payment details on file are able to charge incidental expenditures such as food and beverage purchases and member events to their Member accounts
  • Yes, I would like a Club Account
  • No, I would not like a Club Account

• Settlement Details

  Postgraduate Membership is 12 month fixed term Membership The annual subscription fee applicable to this category of membership is $120.00 per year payable at the time of application submission.
• Please nominate your preferred payment method*
  Please provide your preferred payment method. If you wish to pay via a credit or debit card, please do not provide details in this form. We will contact you to confirm card details in person.
  • Direct Debit from a nominated bank account. Please complete the payment section below
  • Credit or Debit Card - A member of staff will be in contact with you to confirm card details
• Name and branch of your financial Institution
• BSB Number
• Account Number
• Account Name

• Terms and Conditions of Membership

  Postgraduate Membership Postgraduate Membership is available only to CURRENT postgraduate students of UWA. Confirmation of current enrolment in UWA Postgraduate studies must be proven in order to be eligible for Postgraduate Membership. This category of membership is fixed term to expire 12 months after you join. You will be contacted at the start of the month you are due to expire in and if we do not hear back from you the membership will be automatically cancelled on the last day of that month. The following Member benefits are not applicable to the Postgraduate Membership category Monthly subscription payment option, parking privileges and absence privileges. Membership Card I agree to carry and present my membership card when visiting the Club. Assumptions of Liability It is understood that subject to The University Club By-Laws and Regulations, and those that may be enforced from time to time, The University Club of Western Australia shall determine the dues that will be charged to Members. Membership of the Club does not confer upon me any ownership or liability for the property and assets owned by the Club. I agree that I am responsible for the charges incurred by me and my guests in the use of the facilities and amenities of The University Club of Western Australia.
• Declaration
  I have read and understand both the Terms and Conditions of Membership and the “Important Information for Prospective Members” information sheet and agree that acceptance of the Membership application implies that I accept the By-Laws and Regulations of The University Club. I also fully understand that the Membership Sub-Committee reserves the right to approve or reject my application without assigning any reasons whatsoever
  • Yes
• Name
• Date

• Thank you! We look forward to welcoming you to the Club as a Member