Application for Membership Home » Application for Membership If you are human, leave this field blank.Contact DetailsFirst Name *Last Name *Contact Number *Email Address *Address *Apt, suite, etc.CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin IslandsZip codeMembership InterestI have an interest in the objects of Cullunghutti Aboriginal Child and Family Centre (listed below) in the following ways *Objects of Cullunghutti Aboriginal Child and Family Centre are to Provide services to meet Aboriginal Children and families' needs Provide services that culturally match the Local Aboriginal Community Deliver evidence-based services to improve outcomes for children and families, including, but not limited to, health, education and welfare initatives, and a not-for-profit Early Learning Service Provide the aforementioned services for all family and community members beyond the target group initially set by government Ensure the aforementioned services adopt, implement, and promote culturally appropriate processes and protocols Undertake evaluation of the aforementioned services with a methodology that is culturally accepted, and has participation or lead involvement by the local Aboriginal community. The evaluation will take into account outcomes related to cultural identity for children and the local community Influence mainstream (children's, family support, and health services) delivery to improve partnerships, access and referrals, and effectiveness for Aboriginal families Ensure any Centre owned and used by the Association in the provision and delivery of the aforementioned services be staffed and managed (as fully and as practically as possible) by Aboriginal people Ensure the Association maintains the principles of working closely with existing Aboriginal Organisations for the best outcomes for Aboriginal children, their families, and the local Aboriginal community Doing all such acts, deeds, matters, and things as may be incidental, ancillary, or conductive to the attainment and furtherance of these objects To establish a Public Benevolent Institution which will be a Non-Profit Institution, organised for the direct relief of poverty, sickness, suffering, distress, misfortune, disability, or helplessness among the Aboriginal Community which it serves To auspice services and organisations that provide services to peoples of the Shoalhaven and surrounding areas To promote, strengthen, and maintain the social and cultural integrity of Aboriginal communities by ensuring that all programs operate in a culturally appropriate, respectful, and supportive way DeclarationMy qualification to apply for membership is *I am an Aboriginal individual, nominated and authorised as a representative of an Aboriginal organisation from the Shoalhaven Local Government AreaI am a parent, caregiver, guardian, or client who is actively using the services of the associationI am an Aboriginal Elder, recognised and accepted by either an Elder Group or an Aboriginal Organisation, and a permanent resident in the ShoalhavenDeclaration *I hereby apply to become a member of the Cullunghutti Aboriginal Child and Family Centre (Incorporated under the Associations Incorporation Act, NSW 2009), and declare that I am of 18 years of age, or older.I agree to the above declarationCaptcha *reCAPTCHA is required.Submit