Contact information:

Name
Address
Suburb/Town
Postcode
Home Tel
Work Tel
Email
DHS Region

          Here is the description which best fits my/our current situation

          Family Adult person Guardian Agent
          
          Please tell us a little about your need for quality personalised support options:

Membership Fee
Family Membership	$55  Cost (includes GST)
Support Package Service
Families in receipt of support packages (HomeFirst, Support and Choice, Futures for Young Adults, ABI packages) may transfer management of these packages to Families in Partnership. Families transferring their package receive:
One year’s telephone and online support as required
Access to an approved funds manager
Access to an administrator to  employ staff
Free FIP membership	Free

I/We want to sign up as a member of Families in Partnership and

	I will send my cheque/money order to   Social Enterprise Partnerships,
		2 Elm St, North Melbourne 3051
OR

I will make a payment using the secure online credit card payment facility (Visa/Bankcard/Mastercard accepted) CLICK on this link NOW to use our secure payment system. Then close the window and submit this form.

I understand that a tax invoice/receipt will be forwarded to me on receipt of payment.