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The Club
- Our Leadership
- Work With Us
Conferences and Events
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Club Dining
Membership
What’s On
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Membership

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Application Form - UWA Staff Membership.

UWA University Staff - Eligibility Criteria (Please choose which of theses applies to your membership application?) *

I am a current UWA Staff Member and wish to pay fortnightly via payroll - A UWA payroll deduction form will also need to be completed.

I am a current UWA Staff Member and wish to pay monthly from a nominated credit card or bank account. Please provide your staff number in the supporting information box below.

I am a current Adjunct Professor at UWA and wish to pay monthly from a nominated credit card or bank account. Please provide your staff number in the supporting information box below.

Click Here to download the UWA Payroll deduction form if required.

Please Note: You would need to download and upload the Payroll Deduction form only if you select the option - Wish to fortnightly via payroll

Please upload completed payroll deduction agreement

Choose

Payment via fortnightly payroll deduction- please note that a payroll deduction agreement will need to also be completed and uploaded below or emailed to [email protected]. Adjunct Professors are not able to pay via payroll.

UWA Staff Number *

Applicant Details

Have you been a University Club Member previously? *

Yes

No

Title

First Name *

Last Name *

Preferred Name

Street Address *

City (Suburb) *

State *

Postcode *

Country *

Email *

Telephone Number *

Date of Birth *

Club Account and Signing Privileges 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

The Club provides signing privileges through a credit facility for all Members allowing charging food, beverage and event expenditure to their Club account. To set up a Club Account, it is mandatory that Members provide the Club with details of a nominated credit card or transaction account from which these charges can be debited. If you choose to pay your subscription by credit card or direct debit then this account will also be used for payment of incidental charges. Settlement of incidental expenditure is by direct transfer from a nominated credit card or transaction account on or around the 20th of each calendar month. A statement of account will be issued to you in the first week of each calendar month for any membership subscription and incidental charges.

Please nominate your preferred payment method.

Direct Debit from a nominated bank account

Credit or Debit Card

Please provide your preferred payment method. We do not capture card or bank information on form. We will reach out to you to confirm card details in person.

Settlement Details

Declaration - Terms and Conditions - Click Here To View

I have read and understand the Terms and Conditions of Membership and the information provided on this form 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. *

Consent - Code of Conduct - Click Here To View

I have read and agree to The University Club of Western Australia Member's Code of Conduct as set out in the link above. *

First Name *

Last Name *

Date *

Submit

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The University Club of Western Australia, Hackett Drive, Crawley WA 6009. Entrance #1 - Carpark #3

+61 (8) 6488 8770

[email protected]