Membership Form

ANNUAL SUBSCRIPTION - 12 Month membership

Membership flat rate $20

Registered Charity #CC21939

Joining the Wellington Brain Injury Association connects you to a supportive community with exclusive benefits:

Support Groups & Resources – Access local support groups and helpful educational materials.

Regular Updates – Receive newsletters with the latest brain injury news, tips, and community stories.

Exclusive Events & Workshops – Priority invitations to expert talks, rehabilitation sessions, and social gatherings.

Advocacy Opportunities – Help shape policies and raise awareness for better brain injury support.

Please complete the following form

Persons name *

First name

Last name

Persons address

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Address line 2

Address line 3

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Town/Suburb

City

Postcode/Zip

Home phone

Cell phone *

Gender Type

Ethnicity