WiSC - Membership Application Form

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Please complete this form to apply for membership of the Women in Space Chapter (WiSC) of the National Space Society of Australia (NSSA).

This form and the data entered will be kept confidentially by the Executive of WiSC, to be used only for the purposes specified by the WiSC and NSSA charter. The data will not be shared with any other organisation.

You will receive an email confirmation from the Executive of WiSC regarding the status of the application.

NOTE: All questions marked with an asterisk must be answered.

Email *

Family name *

First (and middle if applicable) name *

Email Address (if possible, provide a permanent email, i.e., one not likely to change in the near future) *

Professional/Business Address (if no professional affiliation, provide a personal address or write "None") *

Career Level *

Senior-level Professional

Mid-Career Professional (6-15 years from completion of highest university degree)

Early Career Professional (1-5 years from completion of highest university degree)

Student (Postgraduate)

Student (Undergraduate)

Student (High School)

Self-Employed

Retired

Other:

Area of principal expertise or interest (this can be either the disciplinary field in which you majored at university, or related to your occupation) *

Science

Engineering

Humanities, Social Sciences

Law, Policy, Governance

Business, Economics

Education

Journalism, Media, Outreach

Other:

Phone number

Comments

Send me a copy of my responses.

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