Members Application Form

WSWFVP – Membership Application Form

Membership Application Form

The signing of this document demonstrates the Organisation’s commitment to the Wimmera & South West Family Violence Partnership and that the nominee has read, understood and agrees to comply with the contents and conditions of the Wimmera and South West Family Violence Partnership Partnering Agreement.

Note: if nominating more than one individual, please use a separate nomination form

Agency/Consortia Name *

Name *

First

Last

Position

Email *

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Mailing Address (if different from street address)

Address Line 1

City

State / Province / Region

Postal Code

Country

Membership Type

See Operating Structure at bottom of page for more information (Please tick all boxes that are relevant).

Partnership Member

Commits to actively participating in the majority of Partnership Network meetings (held bimonthly). Eligible for nomination to Governance Committee and/or Deputy Chair roles.

Partnership Interest Member

Members represent organisations and agency staff that wish to be included in Partnership communication and receive network information. Members may wish to never or only occasionally attend Partnership Network Meetings. Partnership Interest members have the option to participate in forums, strategic planning, consultations and other initiatives of the Partnership as they see fit.

Wimmera Local Area Planning Group Member

May include Partnership members or practitioners from Partnership agencies – Local area Members will participate in the Wimmera Local Area Planning Group activities in their region only.

South West Local Area Planning Group Member

May include Partnership members or practitioners from Partnership agencies – Local area Members will participate in the South West Local Area Planning Group activities in their region only.

Questions or Comments

WSWFVP Structure for reference

State Wide Structure

Governance Committee (Systems & Operations)

Chair – Independent Chair
2 x Deputy Chairs
(1x Wimmera and 1x South West)
2 x Auspice Agency Representatives
2 x Tier 1 – Tier 2 Workforce Organisations
2 x Aboriginal Service members
2 x PSAs (Ex Officio Members)

Sets Budget, Monitors Finance & Performance,
Manages Independent Chair, Contract Management

WSWFV Partnership (Networking & Information Sharing)

Chair – Independent Chair
Secretariat Support – PSAs
Participation – Service System Leaders
Develop Strategy & Support Implementation
Engagement & Consultation Mechanism for State & Regional
Reform & Service System

Local Area Planning Group
Wimmera

Chair – Deputy Chair (Wimmera)
Secretariat – PSA Wi

Develop Local Area Action Plans (LAAP)
Oversee LAAP Implementation Projects & Initiatives

Working Groups
as required

E.g. Workforce
& Capacity Building Working Group

Local Area Planning Group
South West

Chair – Deputy Chair (South West)
Secretariat – PSA South West