Annual Membership

First Name *

Last Name *

Email *

Phone *

Date of Birth *

Current Address *

Country *

Employment Information If student or unemployed please mention

Current Position *

How long have you been in this role?

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact Address *

Your Relationship to Contact *

Medical Details - Please list any allergies, or medical conditions we need to be mindful of when you attend our future events *

Areas of Interest *

Community Development
Education
Politics
Religion
Diversity & Inclusion
Migrant & Refugees
Social events
Business
Other

If 'other' then mention here

Children (so we can cater to support their participation)

I authorise the verification of the information provided on this form to be accurate, and that I am agreeing to an annual membership with KLN. I understand that the terms of the membership are for a year and costs to membership apply in the future. *

Submission date *

Thank you for submitting the membership form.

We appreciate your support. One of our team members will send you confirmation soon.

Have a great day!

Thank you for submitting the membership form.

We appreciate your support. One of our team members will send you confirmation soon.

Have a great day!

Annual Membership

Are you still considering becoming a member of KLN? Here are some reasons why you should join today!

Join today