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Membership Checkout

Membership Level change

You have selected the Industry Member membership level.

Industry membership is for individuals who do not provide direct patient care. Industry members do not have voting rights.

Please note that all memberships are subject to an approval process by the PiCSA Board. You will be able to access your billing account immediately, however access to PiCSA resources will be unavailable until your membership has been approved.
Your membership is valid for one year from your sign-up date.

The price for membership is

$110.00

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Password

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Email Address

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Full Name LEAVE THIS BLANK

Personal Information

First Name

Last Name

Gender

Male

Female

Employment Details

Job Title

Main Specialty

If you selected Other, please specify your Main Specialty

Primary Employment Type

Current Employer

Employer Department

State

Date Commenced Current Position

Undergraduate Degree Information

Undergraduate Degree

Undergraduate Institution

Completion/Expected Completion Date

Undergraduate Degree Certificate or Current Proof of Enrolment

Allowed File Extensions: .pdf, .doc, docx, .png, .jpg. Maximum File Size 5MB.

Post-Graduate Course Information (if applicable)

Post-Graduate Course

Post-Graduate Institution

Completion/Expected Completion Date

Post-Graduate Course Certificate or Current Proof of Enrolment

Allowed File Extensions: .pdf, .doc, docx, .png, .jpg. Maximum File Size 5MB.
* If submitting details about a Post-Graduate Course, a Course Certificate or Proof of Enrolment is required.

Other Relevant History

Significant Industry Experience (Grandparented)

Date Started Working in the Industry

Approximate Full Time Equivalent Years Worked

Previous Employment History

What benefits do you hope to gain through your PiCSA membership?

Are you registered with the Australian Council for Clinical Physiologists (ACCP)?

Yes

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I confirm that the information I have submitted is accurate and correct. Responses cannot be edited after submission.

Would you like to set up automatic renewals?

Yes, renew at $88.00
Automatically renew your membership to receive a 20% discount on subsequent yearly membership renewal fees.

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