Change of Details

Members are invited to use this form to submit any changes to their membership details online.

Only complete changed details where necessary.

Don't forget to fill in your name or the changes cannot be processed!

Your Details
Member number [if known]:
Member name:

Workplace
New workplace:

Home Address
Street address:
Suburb:
State / Postcode:	/

Salary Step
New incremental step:

New Employment Status Have you become permanent, taken on a contract, become part-time, reduced your load, or as a casual increased/reduced your hours, gone on LWOP or become an Associate. Use the boxes below to indicate any changes.
Permanent
Full time	Contract
Permanent Part-time	%
Casual	0-1 days 2-3 days 3+ days

Leave without pay	Note: Fees will be suspended while on LWOP
Associate membership	Note: $30 per annum - appropriate if retiring or a student teacher

Resignation from AEU - ACT Branch I wish to resign from the AEU - ACT Branch.
Reason for resignation:
Date of resignation:
Have you also resigned from the Department? Yes No