MyImpactPage - Gosnells/Migrant Refugee South

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Account

Username

Required

	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Confirm Password

Required

	Password needs to have at least 12 characters.
	Password needs to have at least one upper case character.
	Password needs to have at least one lower case character.
	Password needs to have at least one number.
	Password cannot be on a list of commonly-used passwords.

Name Fields

Salutation
Legal First Name
First Name Required
Middle Name
Last Name Required
Suffix
Pronouns

Address

Address line 1 Required
Address line 2
City Required
Country Required
State / Province Required
Zip / Postal Code Required

Email Addresses

Email Address Required
Secondary Email Address
Mobile Email
* Not available in all areas. View Mobile Email Information here.

Phone Numbers

Required Please enter at least one phone number

Home Phone
Work Phone
Work Extension
Cell Phone
Phone Preference

Online Presence

X Username @
Linkedin Profile URL
Instagram Username

Misc Fields

Region

ABOUT YOU

Gender

HOW DID YOU LEARN ABOUT CONFERENCE MEMBERSHIP?

An Existing Member

Parish

Retail Shop

SEEK

Vinnies Website

Word of Mouth

Other (Please specify)

EMERGENCY CONTACT PERSON (Person we should contact in case of an emergency)

Name

Phone Number

Relationship

SECONDARY EMERGENCY CONTACT PERSON

Name

Phone Number

Relationship

DECLARATION

I understand that in order to be considered for a volunteering role with Vinnie's, that I need to undergo a National Police Check or provide evidence I have a current clearance less than 3 months old

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