Professional Membership Form Professional Membership Application Form For any enquiry, please contact membership@vicwise.org Type of membershipsProfessional (non-transferable) - $100 + GST, valid for one year (Jan-Dec)Professional (transferable) - $150 + GST, valid for one year (Jan-Dec)Applicant informationStatusPendingActiveCancelledExpiredStart DateExpire DateTitle*Please choose oneMrMsMrsMissOtherFirst Name*Last Name*Position/Job title*Organisation name*Street addressSuburb/Town*State/ProvincePost code/ZIP code*Phone number*Email address*SeparatorTerms & Conditions*Submit.*.I have read and agree with the terms and conditions of VicWISEPassword* Error occured. Please confirm your data and submit again: