august, 2024 Basic Possum Workshop Part II 04aug9:00 am4:00 pmBasic Possum Workshop Part II Event Details Event Details Free Workshop Booking FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 4Select your Membership? *Book Free Workshop/s (Members Only)Join as a 'New' Member & Book 'Free' Workshop/sRenew Membership & Book 'Free' Workshop/sPlease ensure you are a current member otherwise select "Join or Renew" and you will be able to become a "New" member or "Renew" your membership and also book yourself in to our FREE workshop!Select type of application?New MembershipRenewal of an Existing MembershipA membership renewal is much more simplified process for our existing members. New Members must complete the New Membership to provide all of the necessary information for review.Select the type of Membership for this application *Single $34.50Family $49.50Memberships are non refundable. Family memberships can consist of up to 2 adults, 2 children living at the same addressFamily Membership - Select Members of familySecondary Adult MemberChild (1st)Child (2nd)Family memberships allow for up to four household members to apply under the family membership option. LayoutName (Primary Member) *FirstLastMobile Number (Primary Member)Date of Birth *Email (Primary Member) *Family Membership (Secondary Adult Member)LayoutSecondary Member Name (Family Membership Only)FirstLastOnly complete this section if you selected the family member application type option. Mobile Number (Secondary Member)Email (Secondary Member)Leave empty if not applicable.Date of Birth (Secondary Member)Leave empty if not applicable.Family Membership (Children)LayoutChild Name (First)FirstLastPlease complete to add any children to the application for a family membership application onlyChild Date of Birth (First)Leave empty if not applicable.Child Name (Second)FirstLastPlease complete to add any children to the application for a family membership application onlyChild Date of Birth (Second)Leave empty if not applicable.NextPersonal InformationAddressAddress Line 1CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryLayoutEmergency Contact Name (For Primary Member) *FirstLastEmergency Contact Relationship *PhoneHas your address changed since your last application?NoYesAddressAddress Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryAre you planning on attending the workshop with any "Members" that are under your existing "Family Membership"?NoYesPlease include all names of additional Members you are booking for: PreviousNextGeneral Background & ExperienceLayoutAre you a current member or been a member of another wildlife organisation? *NoYesHave you ever been denied a Wildlife Rehabilitation Permit or had one cancelled or revoked by either a wildlife organisation or the DES (Department of Science)? *NoYesPlease identify the wildlife organisation you are a member or have been a member of belowIf you answered No to the previous question please leave this field blank. Please describe, if any, your previous wildlife experience?Please leave blank if you do not have any experience. Have your emergency contacts changed since your last application?NoYesLayoutEmergency Contact Name Update Emergency Contact RelationshipE.g. Husband/Wife/Mother/Father/Brother/Sister etc.Emergency Contact Phone UpdateSelect 'Free' Members Workshops you will be attending with us? *1. INDUCTION TO NATIVE BIRDS -- SATURDAY 16TH NOV 2024 -- 9AM-3PM2.INDUCTION TO POSSUM -- SUNDAY 17TH NOV 2024 -- 9AM-3PMLocation of workshops are in Beerwah. TBAPreviousNextPayment & Complete Form SubmissionPlease select your preferred payment method *Secure Credit Card PaymentSecure PayPal PaymentBank Transfer (EFT) DepositFor ETF/Bank Transfers Please use Westpac Bank - Account Name: Wildlife SEQ Inc. - BSB Number: 034 243 - Account Number: 365 050Select Membership Type for Secure Credit Card PaymentSingle Membership - $34.50Single Membership - $34.50Family Membership - $49.50Please manually select the membership type from the dropdown list. Secure Credit Card Payments Online (Square Payments) *CardName on CardSquare Payments Provider supports WildlifeSEQ Inc with secure online payments for our members. WildlifeSEQ Inc does not collect, store or process your credit card details. Total$0.00LayoutPayPal Secure Online Payment Method Once you read & accept the terms and conditions below click on Submit and you will be redirected to PayPal payment gateway to securely process your membership payment. LayoutBank Account Transfer Use the following Bank Account Information for transfer via EFT/Deposit – Westpac Bank – Account Name: Wildlife SEQ Inc. – BSB Number: 034 243 – Account Number: 365 050 By becoming a member of Wildlife SEQ Inc. you agree to: 1. Abide to all content included in all workshop manuals when carrying out any tasks on behalf of Wildlife SEQ Inc. 2. Abide by the organisations core values, policies and procedures 3. Agree to follow and adhere to Wildlife SEQ Inc. Safety Practices 4. Abide by the rules set out in the following legislation (policy will be emailed) - Code of Practice – Care of Sick, Injured or Orphaned Protected Animals in Queensland As part of our application process Wildlife SEQ collects personal information and matter including name, address, phone number, email address, training and experience. This information may be released to other relevant wildlife organisations including but not limited to Australia Zoo Wildlife Hospital, Department of Science (DES), RSPCA if required. Wildlife SEQ Inc. accepts no liability for any personal injury, death, property damage/loss or financial cost arising from any voluntary work undertaken on behalf of the organisation. Wildlife SEQ Inc. holds Public Liability Insurance in the amount of $20,000,000. *I accept the above terms & conditionsAre you interested in any of the following volunteer roles? Wildlife CarerAnimal TransportationWildlife RescueOur Wildlife Needs your Help!!! WildlifeSEQ Inc. are recruiting volunteers for the abovementioned roles. Please select any or all that you would be interested in and we will reach out to you with further information at a later time. How would you rate this booking experience?Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Submit & Book Workshop Time (Sunday) 9:00 am - 4:00 pm LocationTo be advised CalendarGoogleCal