OFFICER DETAILS

Your Details

First name

Last name

UQ Student Number

Phone

Date of Birth

Day

Month

Year

Address

Post Nominals (abbreviations indicating qualifications, honours)

Shirt Size?

Unisex: S = 52 cm to 3XL = 70 cm chest width, or Women’s Fit: Size 8 = 46.5 cm to Size 24 = 68 cm chest width.

Temporary headshot for the website (not compulsory)

TFN (write 'No TFN' if you don't have one)

Do you have an ABN (Australian Business Number)?

Yes

Bank Name

Bank Account Name

BSB

Account Number

Please upload the completed and signed Honorarium Declaration and Code of Conduct form listed above

Signature

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