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, you will be over 18 years of age and reside in the State of Victoria.

You can save and return to this form at any time. This form is Stage 1,after completion, if you would like Combined Liability Insurance cover 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.
Your membership will be valid once your payment has been received, either via the PayPal link at the end of this form or via invoice and bank transfer.
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.

Questions?
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 Individual Membership

If you are a renewing Member your name must appear exactly as pre-filled below. If the name has changed please contact us prior to completing this form.

First Name

Last Name

Are you over the age of 18?

YesNo

Is your principal place of residence in the State of Victoria, Australia?

YesNo

What was your gross income from your arts activities for the last year, including grants (include the last financial year that you have completed your tax return). If this is your first year working as an artist and you have no current income from arts activities 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 Membership. If you would like to stay in touch with Regional Arts Victoria please sign up for our enews here

This period

Page 2 - Contact and Activity Details

Contact Information

Mobile Phone Number

Other Phone

Email

Website (if any)

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 Address

Suburb

State

Postcode

Government

In which Local Government Council or Shire are you based?
If unsure click here.

In which State Government Electorate are you based?
If unsure click here.

In which Federal Government Electorate are you based?
If unsure click here.

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 current activities and events

Page 4 - Insurance

OPTIONAL Combined Liability Insurance - including public liability

Regional Arts Victoria offers its Organisation Members access to optional Combined Liability (public liability, product liability and professional indemnity) Insurance for an additional fee. See Combined Liability policy information here.

Would you like to add Combined Liability Insurance to your membership purchase?

Yes, please add to my purchaseNo, I am not interested in this option at the moment

Membership Promotion Code

If you have one, please enter your promotional code

Submit Promotion Code

Membership Fee Summary

TOTAL Membership Fee $35.00

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

Membership Fee Summary

TOTAL Membership Fee $17.50

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

Membership and Insurance Fee Summary

Membership Fee $35.00

Combined Liability Insurance Premium $120.00

TOTAL $155.00

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

You will not be insured until you have completed your insurance application via the GSA website. You will be directed to the page to complete this form at the end of the payment screen.

Membership and Insurance Fee Summary

Membership Fee $17.50

Combined Liability Insurance Premium $120.00

TOTAL $137.50

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

You will not be insured until you have completed your insurance application via the GSA website. You will be directed to the page to complete this form at the end of the payment screen.

Page 5 - Form Submission

Confirmation

Declaration

I confirm that the information I have provided in this form is true and correct.

Full Name

Date

Please use the Previous Page button or Page Number Navigation to review your form carefully prior to finalising.

Click Submit the Application to complete Stage 1. If you have selected optional Combined Liability Insurance please continue to Stage 2: Complete your insurance application through the GSA website.

Thank you, we look forward to welcoming you as a RAV Member in 2023-2024.

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

Page 2 - Contact and Activity Details

Postal Address

Page 3 - Working With Us

Page 4 - Insurance

TOTAL Membership Fee $35.00

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

TOTAL Membership Fee $17.50

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

Membership Fee $35.00

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

You will not be insured until you have completed your insurance application via the GSA website. You will be directed to the page to complete this form at the end of the payment screen.

Membership Fee $17.50

Please allow 10 business days for your application to be processed.

Your application will be checked for eligibility.

At the end of this form you will be directed to a PayPal screen to pay. If you do not wish to use PayPal close this screen and we will send you an invoice.

Once payment has been received, we will send you confirmation of your membership and insurance.

You will not be insured until you have completed your insurance application via the GSA website. You will be directed to the page to complete this form at the end of the payment screen.

Page 5 - Form Submission