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Hello,

Thank you for choosing to become a Regional Arts Victoria Member!

Our aim is to support regional creatives and creative organisations to thrive.

To be eligible for membership of Regional Arts Victoria, your organisation will be:

incorporated in the State of Victoria, Australia; or have its principal place of business in the State of Victoria, Australia;
and have the promotion of regional arts or cultural pursuits as a primary or principal focus;
and be a not-for-profit or charitable organisation;

You can save and return to this form at any time. This form is Stage 1, after completion you will be directed to Stage 2: Complete your insurance application through the GSA website.

Please note:
Please allow 10 business days for your membership application to be processed. Please note insurance applications can take 2-4 weeks to be approved.
Your application will be checked for eligibility and once approved you will be invoiced for payment. Once payment has been received, we will send you confirmation of your membership.
If you have selected optional Combined Liability Insurance cover you will receive a certificate valid until 31 October 2023 and in late October you will receive a certificate valid until 31 October 2024.

Insurance - Stage 2:
Please note the eligibility for our insurance offerings. You will be directed to Stage 2: Complete your insurance application through the GSA website at the end of this form to confirm your insurance details.

Questions?
If you require more information about Membership or insurance, please go to the FAQs available on our website.

If you require assistance with the online form, please contact the Regional Arts Victoria Membership team at membership@rav.net.au or by phone on 1300 882 531

Membership Terms and Conditions

I have read and understood the Membership Terms and Conditions.

Eligibility for Organisation Membership

Organisation Name

Organisation Name
Contact us if your name has changed.

Is your organisation incorporated in the State of Victoria, Australia? Or is your organisation's principal place of business in the State of Victoria?

YesNo

Does your organisation have the promotion of regional arts or cultural pursuits as a primary or principal focus?
(e.g. Your organisation runs regional events or works with regional artists)

YesNo

Is your organisation a registered not-for-profit or charitable organisation?

YesNo

What was your gross income for the last year, including grants (include the last financial year that your organisation has completed a tax return). If your organisation is new and you have no current funding please enter 0.

Numbers Only! 10000 not $10,000

Ineligible

Based on your responses above, we are sorry to say you are not eligible for Organisation Membership. If you would like to stay in touch with Regional Arts Victoria please sign up for our enews here

Ineligible for master Combined Liability Insurance policy

Based on your response that your organisation has a gross annual income over $1,000,000, you are eligible for Organisation Membership and Association and Volunteer Workers insurance. However, you do not qualify for our master Combined Liability insurance policy. Please continue the form if you would like to continue your membership application. Contact us if you have any questions.

renewal

yesno

pli

yesno

accYes

yesno

mem

ThisMonth

acc

period

Organisation Information

Organisation Phone Number

For general enquiries

Organisation Email

For general enquiries

Membership communications will only be sent to the nominated Primary Contact

Organisation Website

Postal Address

Traditional Place name (if usure please leave blank)

Further information: https://aiatsis.gov.au/explore/map-indigenous-australia

Mailing Street Address

Mailing Suburb

Mailing State

Mailing Postcode

Is your street address different from the above?

Street Address Information

Traditional Place name (if usure please leave blank)

Further information: https://aiatsis.gov.au/explore/map-indigenous-australia

Street

Suburb

State

Postcode

Government

Which Local Government Council or Shire is the organisation based in?
If unsure click here.

Which State Government Electorate is the organisation based in?
If unsure click here.

Which Federal Government Electorate is the organisation based in?
If unsure click here.

Office Bearers

List your Organisation's Office Bearers below. You will also be asked to nominate a member of your committee as a Primary Contact and Voter.

The Primary Contact will receive all renewal information, insurance information and all other notifications from Regional Arts Victoria.

The Nominated Voter will receive all information about Board nominations, voting processes, Annual General Meetings and Special General Meetings.

President

First Name

Last Name

Mobile Phone

Other Phone

Email

Secretary

First Name

Last Name

Mobile Phone

Other Phone

Email

Treasurer

First Name

Last Name

Mobile Phone

Other Phone

Email

Primary Contact

The primary contact will receive all renewal information, insurance information and all other notifications from Regional Arts Victoria by email.

Nominated Voter

The Nominated Voter will receive all information about Board nominations, voting processes, Annual General Meetings and Special General Meetings by email.

About the Organisation

What are the key aims and objectives of the organisation?

What are the main art forms of the organisation? Check all that apply.

Circus	Community Arts
Craft	Cultural Development
Dance	Digital Media
Festival	Film
Jewellery	Literature
Multi-art form	Music
Performing Arts	Photography
Sculpture	Textiles
Theatre	Visual Arts
Writing	Other

Other art form

Activities and Events

How many activities and events did you deliver in the last year?
Where people engaged directly with your organisation for an activity (do not include social media, website or subscriber communications

How many people did you reach through your activities and events in the last year?

If unsure, please estimate

Please describe some of your organisation's current activities and events

Members and Volunteers

Please tell us about the members and volunteers working with the organisation.

Number of members:

If unsure, please estimate

Number of volunteers:

If unsure, please estimate

Number of volunteer hours in the last year:

If unsure, please estimate

Equity and Diversity

Regional Arts Victoria is committed to ensuring everyone can access the arts. Capturing data on the diversity of our members is one of the ways we can measure our progress and set goals for continual improvement.

The below section is optional and will assist us in evaluating how inclusive our program is over time.

Which age ranges apply to your committee and volunteers? Tick all that apply.   

Young People (12 - 25 years)Adults (26 - 59 years)Seniors (60+ years)

Which age ranges apply to your members or the community in which you serve? Tick all that apply. 

Children (0 - 11)Young People (12 - 25 years)Adults (26 - 59 years)Seniors (60+ years)

Please select all of the boxes that apply to your Organisation or Group or select 'none of the above'

First PeoplesPeople from culturally & linguistically diverse backgroundsPeople who are deaf and/or living with a disability People who are lesbian, gay, bisexual, trans and gender diverse, intersex and/or queer (LGBTQI+)Low-income None of the above

Why does your organisation wish to become a Member of Regional Arts Victoria?

NetworksInsuranceSupport and adviceFunding informationNews and opportunitiesPromotion of our organisation and eventsSupporting the arts in Victoria

Are there any other reasons why you are joining Regional Arts Victoria?

How did you hear about Regional Arts Victoria?

Other

Regional Arts Victoria has a number of programs that may be of interest to Organisation Members. Please select which of the following mailing lists you would like to subscribe to.

You can unsubscribe at any time from the below lists. Read RAV's Privacy Policy here.

RAV Monthly ENews Brief Description

YesNo

Arts & Education ENews Brief Description

YesNo

Community Presenters Brief Description

YesNo

Touring Artists - Regionally-based Brief Description

YesNo

Touring Artists - Statewide Brief Description

YesNo

INCLUDED Association Liability and Volunteer Workers' Insurance

As part of your Regional Arts Victoria Organisation Membership you are eligible to apply for Association Liability and Volunteer Workers cover under RAV's master insurance policy. You will need to go to step 2 at the end of this form and complete your insurance details in GSA Insurance Broker's website to be covered.

Association Liability cover is essential to protect your organisations directors, office bearers and committee members in the incident of a claim for a wrongful act. Visit this page to learn more.

Personal Accident Insurance for Volunteer Workers protects volunteers and members of your organisation from expenses incurred due to injury sustained while engaged in official unpaid voluntary activities (this could even be during a meeting). Visit this page to learn more.

OPTIONAL Combined Liability Insurance (including Public Liability)

Regional Arts Victoria offers its Organisation Members access to optional Combined Liability Insurance (public, professional, product liability and professional indemnity) for an additional fee, calculated based on gross annual income.

Would you like to add Combined Liability Insurance (inc. Public Liability) to your membership purchase?

YesNo

Organisation income range

Please indicate your organisation's gross annual income range from the last financial year to calculate the total fee applicable. This is your organisation's total income before tax including all grants. Please ensure the band matches your answer to the income question on page 1 of this form. If your organisation is new and you have no current funding please select the first band.

Up to $5,000$5,001 to $10,000$10,001 to $20,000$20,001 to $50,000$50,001 to $100,000$100,001 to $200,000$200,001 to $500,000$500,001 to $1,000,000 (over $1,000,000 not eligible)

By checking the below box I confirm that the above gross annual income information is true and correct. I understand that if this information is incorrect the organisation may not be covered for insurance claims related to the Regional Arts Victoria Combined Liability master policy. I understand that the insurance application is not complete until approved by GSA Insurance Brokers

I have provided true and correct information about the organisation's gross annual income.