Application Form for Affiliate

Application Form for Affiliates of Bionics Queensland

Applying to become an Affiliate of Bionics Queensland Incorporated – This application form for individuals seeking to become a Bionics Queensland affiliate should be attached to a brief email or letter sent to the Interim CEO of Bionics Queensland, Dr Robyn Stokes (c/- 29 Nathan Avenue, Ashgrove, Qld, 4060). As soon as your application has been approved, we will contact you for payment of related annual fees , provide you with further details on our policies and the timing of our newsletter updates on human bionics discoveries and key events and activities. Click here to read our Summary of Benefits and Fees for Affiliates.

Application form