1 Start 2 Additional Info 3 Review 4 Complete Full Membership of Living Positive Victoria is FREE and is open to any person in VIC/TAS living with HIV. Members receive a free subscription to Poslink, an Annual Report and occasional mail/email updates. You can choose your preferences in the form below. Applications for membership must be approved by the Living Positive Victoria Board of Directors. Full members may be asked to provide verification of HIV status. The Rules of the Organisation are available online at livingpositivevictoria.org.au or can be requested by contacting 03 9863 8733. Your Details I am applying as a * Full member (I am a VIC/TAS resident living with HIV) First Name * Last Name * Email * Phone Number * Birth Date * Day12345678910111213141516171819202122232425262728293031 Day MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Year19211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021 Year What is your current gender identity? * - Select -FemaleMaleTrans Female/trans womanTrans Male/trans manIndigenous BrotherboyIndigenous SistergirlNon-binary/gender fluidIntersexOther Other (Please Specify) * Street Address * City * State * - Select -TasmaniaVictoria Post Code * I would like a member login associated with this email account * Yes No Leave this field blank Next Page >
