Join The ARA

Membership applications are submitted initially to the ARA Secretariat, after which they are forwarded to the relevant State Honorary Secretary for consideration at Branch level. Applications approved at State Branch level will be tabled at ARA Board Meetings and Annual General Meetings for ratification.

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Title :

Given Name :

Surname :

Date of Birth (dd/mm/yyyy eg 31/12/2016)

Membership :

State Membership :

Correspondence Email:

Gender:

Qualification :

MD
MBBS
MD or MBBS Equivalent
N/A

MD or MBBS Equivalent:

Institution:

Date

FRACP Admission Date :

AHPRA Registration Number

AdvancedTrainee

If you have any special circumstances relevant to this application please include them below.

Special Circumstances

Current Employment

CV File ( pdf, doc or docx)

Proposer

Name :

Seconder

Name:

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