Registration Form Please complete your details below and press the Join button when completed to join SPEVI. Personal Details Title First Name * Last Name * Country * Australia Cook Islands Fiji French Polynesia Guam Kiribati Marshall Islands Micronesia Nauru New Caledonia Niue Northern Mariana Islands Palau Papua New Guinea Samoa American Samoa Solomon Islands Timor-Leste Tokelau Tonga Tuvalu Vanuatu Wallis and Futuna Outside Pacific Islands and Australia Please type your Country Here State or Province Organisation / Affiliation Role * Select Role ... EducatorParent/CarerVI ProfessionalOther (please specify) Email * SPEVI Journal (published annually) The SPEVI Journal will be posted to the SPEVI website annually and available for download. All members will be notified of its availability by email. SPEVI Email List options SPEVI Members Only List The SPEVI members’ email list is the main method of communication between members. You are encouraged to share information and ideas with your SPEVI colleagues. SPEVI List The general SPEVI email list is open to any professionals, families and caregivers who wish to share and receive information about education of children and young people with vision impairment. Membership Type Category 1 - General Member $110.00 AU; Free for Pacific Islanders This category of membership is open to educators and other professionals and parents/caregivers who support and promote quality education for children and young people with vision impairment. Membership includes the opportunity to join SPEVI’s committees, working groups and SPEVI Community of Practice, discounted registration for SPEVI conferences and professional learning opportunities, access to the members-only email list, and a single vote at SPEVI meetings. Category 2 - Qualified Specialist Teacher (Vision Impairment) $110 AU; Free for Pacific Islanders This category of membership is open to teachers with tertiary qualifications in vision impairment education. Membership includes the opportunity to join SPEVI’s committees, working groups and SPEVI Community of Practice, discounted registration for SPEVI conferences and professional learning opportunities, access to the members-only email list, and a single vote at SPEVI meetings. When submitting your membership application, please upload your academic transcript (or other evidence) of your studies in vision impairment education. Category 3 - Associate Member $50 AU; Free for Pacific Islanders This category of membership is open to any personnel supporting persons with vision impairment, including parents/caregivers of individuals, school ancillary staff, volunteers, retired professionals in vision impairment education, and tertiary students completing studies in vision impairment. Associate membership includes discounted registration for SPEVI conferences and professional learning opportunities, and access to the members-only email list. Associate members are not entitled to vote at SPEVI meetings. Documents confirming your studies in vision impairment education Upload your Documents Select one or more files from your computer containing your academic transcript (or other evidence) of your studies in vision impairment education confirming you are a Qualified Specialist Teacher in Vision Impairment. If you make a mistake and select the wrong file, press the Clear File List button and that will remove all files. You can then select the files to upload again. Payment Details Please enter your credit card payment details in the following fields to complete your payment. We accept VISA and Mastercard. If you are unable to pay the membership fee via our secure payment system, please send us an Email at spevisecretaryATGMAILcom and we will advise you of alternative options. Name on Card Card Number Card Expiry Month / Year Month ... 123456789101112 Year ... 20232024202520262027202820292030203120322033 Card CVN For New Zealand Membership please contact: xxxxx