Addition of Child Form

CHILD 1:*
FIRST NAME: MIDDLE NAME: SURNAME:
CHILD 1 - DATE OF BIRTH:*
CHILD 2:
FIRST NAME: MIDDLE NAME: SURNAME:
CHILD 2 - DATE OF BIRTH:
CHILD 3:
FIRST NAME: MIDDLE NAME: SURNAME:
CHILD 3 - DATE OF BIRTH:
PARENT DETAILS
Your Email Address*
MOTHERS FULL NAME:*
FIRST NAME: MIDDLE NAME: SURNAME:
MOTHERS DATE OF BIRTH:*
FATHERS FULL NAME:*
FIRST NAME: MIDDLE NAME: SURNAME:
FATHER DATE OF BIRTH:*
MOBILE:*
REQUIREMENTS OF ADDING A CHILD/CHILDREN
In order to a child/children, one parent must be a registered member of Wajarri Yamaji Aboriginal Corporation and you must provide a copy of each child's birth certificate.
WYAC MEMBERSHIP
- Mother is a registered member of Wajarri Yamaji Aboriginal Corporation
- Father is a registered member of Wajarri Yamaji Aboriginal Corporation
- Both Parents are registered members of Wajarri Yamaji Aboriginal Corporation
CHILD'S BIRTH CERTIFICATE*
Please upload a copy of your child's birth certificate. You can upload a PDF, JPEG or Microsoft Word document.
Drop files here or

Accepted file types: pdf, jpg, doc, docx, Max. file size: 10 MB.
TO ACCEPT, TYPE YOUR NAME BELOW*
For any application enquiries please contact the office on 08 9997 3444 or email members@wajarri.com.au

PARENT DETAILS