Forms

PROBATION AND COMMUNITY CORRECTIONS OFFICERS' ASSOCIATION

'Our goal is to enhance the quality of Justice and the safety of the Community

through our professional development and participation in relevant issues'

Delegate contact information, State & Territory News

Updated: 25th October 2008

PACCOA

Questions or problems regarding

Printed form	Print an application form, complete the details and forward the form to the Delegate in your jurisdiction.
Electronic	Alternatively, you can complete the details in the membership application form below and submit by e-mail.
	In each case you will need to print out a deduction authority and forward that to your Delegate.
	Use this form to update your membership details

PROBATION AND COMMUNITY CORRECTIONS

OFFICERS' ASSOCIATION

PO box 1327 Parramatta NSW 2124

(Incorporated under the Associations Incorporation Act, 1984 (NSW))

ABN: 97 637 750 898

APPENDIX 1(Rule 5 Clause (1))

I (First name) (Surname)

OF (Home address (Street/P.O. Box – City - Postcode)

AND (Work address) (Street/P.O. Box – City - Postcode)

(Contact phone number)

POSITION TITLE:

(Organisation title; e.g. Community Corrections, Community Based Services, etc)

(Email address)

Hereby apply to become a member of the abovenamed Incorporated Association. In the event of my admission as a member, I agree to be bound by the Rules of the Association for the time being in force and to conduct myself in accordance with the Association Code of ethics.

Date

A deduction authority form has been completed and forwarded to the Delegate in my jurisdiction Yes No

PROPOSER

I (First name) (Surname)

a member of the Association, nominate the applicant, who is personally known to me, for membership of the Association.

Date

SECONDER

I (First name) (Surname)

a member of the Association, second the nomination of the applicant, who is personally known to me, for membership of the Association.

Date

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PROBATION AND COMMUNITY CORRECTIONS

OFFICERS' ASSOCIATION

PO box 1327 Parramatta NSW 2124

(Incorporated under the Associations Incorporation Act, 1984 (NSW))

ABN: 97 637 750 898

NAME:     (First name) (Surname)

OF               (Home address (Street/P.O. Box – City - Postcode)

AND          (Work address) (Street/P.O. Box – City - Postcode)

                    (Contact phone number)

                    POSITION TITLE:



                    (Organisation title; e.g. Community Corrections, Community Based Services, etc)

                    (Email address)

                    Subscription payment method: If other, please specify

Date

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