Membership Form

 

Note: due to a change in committee structure there may be a delay in processing online memberships. Please contact us via the email tab at the top of this page if you have any queries.

Complete the form below to become a member of Dyslexia SA.

Membership is free. You can choose either “Dyslexia SA general membership” or membership of one of the Dyslexia SA branches listed.

First Name *

Last Name *

Postal Address 1 *

Postal Address 2

Suburb *

State *

Postcode *

Phone Number

Mobile Number

Email Address *

I am... *

Other

Branch *

I acknowledge that:

  • I will act in accordance with the Dyslexia SA constitution, otherwise my membership will be cancelled and any monies paid (if applicable), forfeited.
  • I am consenting to Dyslexia SA, or the relevant Branch I am affiliated with, storing and using my contact details during my term as a member of Dyslexia SA.
  • I can resign from Dyslexia SA and a Branch at any time by writing to Dyslexia SA or the Branch Secretary.
  • Resignation from Dyslexia SA, automatically means resignation from a Branch.

I Agree

* Required field