Student Member Application

Your Title & Given Name *

Select... MrMsMrsMxDr  

Family Name *

Your Date of Birth *

DD 01020304050607080910111213141516171819202122232425262728293031 MM 010203040506070809101112 YYYY 20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926

Email Address *

Phone Number *

Address (line 1) *

Address (line 2)

Town or City *

State *

Select state... VictoriaNew South WalesAustralian Capital TerritoryQueenslandNorthern TerritoryWestern AustraliaSouth AustraliaTasmaniaOther

Post Code *

AIPI Membership Chapter *

Select your chapter... VictoriaQueenslandNew South WalesSouth AustraliaAustralian Capital TerritoryWestern AustraliaNational

Have you ever been known by or used another name? *

Have you previously applied to join the AIPI? *

Have you ever had an application for membership of a professional organisation rejected? *

Are you working full time in any field? *

Have you ever been charged with a criminal offence where the charge has been proven? *

Are you aware of any other event, which may impact adversely upon your integrity or credibility as a professional investigator? *

Current Qualification/Course details *

Expected finish Month/Year *

MM 010203040506070809101112 YYYY 20262027202820292030203120322033203420352036

Organisation or School Name *

Contact Name *

Email Address *

Mobile Number (if available)