Join ACORN Queensland

Please complete the following application form to become a member of ACORN QLD (formerly PNAQ)

Membership to ACORN Queensland is $110 per annum for full Members and $55 per annum (includes GST) for students/affiliates.

Payment is required at time of application. Once you have completed the form, you will be directed to our secure payment page

If you do not wish to proceed with this application, please click on the CLOSE tab to the right

If you have previously been a member of ACORN QLD (formerly PNAQ), please DO NOT complete this form - proceed to our Membership Page and select to Renew or Reinstate your membership in order to login and bring your account up to date.

Students are classified as Undergraduate Students with a student ID

Affiliates are classified as industry partners and non perioperative nurses

If the incorrect membership is chosen a member of the committee will contact you

Account or Representative Details

Title

First Name

Middle Name

Last Name

Username

Password

Confirm Password

Membership Product

Organisation Name

Are you currently an undergraduate student?

Yes

Country

Address 1

Address 2

City/suburb

State

Postcode

Phone Contact (at least one phone number is required)

Phone Number

Business Phone

Mobile Number

Employment Information

Place of employment

Not currently employed

Department

Practice Stream

Position

Level

Other Details

Introduced By (Must be a current ACORN QLD Member). If renewing enter RENEWING

Previous ACORN QLD (formerly PNAQ) committee positions held

Are you currently registered with AHPRA?

Yes

AHPRA Registration number

Terms and Conditions

Would you like to apply now? If so, please confirm your details below, tick the boxes below and then Click "Apply Now".

By completing this form and applying for ACORN QLD membership:

I agree to become a member of our national body, the Australian College of Perioperative Nurses Limited (ACORN) and to be bound by the memorandum and articles of the College.

I Agree