We will discover, innovate and achieve more with you involved!

How to become a Bionics Queensland Associate

Organisations applying for Associate status should complete the online application form below. If you would like to further discuss the benefits of becoming an Associate or ask questions at the time of submitting your application, please call Dr Dimity Dornan on 07 3850 2111.

Upon receipt of your application, we will contact you to provide further insights on benefits and opportunities, fees and payment.

Click here to read our Summary of Benefits and Fees for Associates.

Application form

Company Details
Company Name*
Company Address*
Street Address Address Line 2 City State / Province / Region Post Code Country
Website/URL*
Representative Details
Title*
First Name*
Last Name*
Position*
Phone Number*
Email*
Other Representative Details

Names and email addresses of other Representatives (max 4)

First Name	Last Name	Email

Additional Details
Which area(s) best describes your Organisations interest in Bionics?
- Select All
- Bionic senses – hearing, vision, touch, taste, speech, emotion
- Bionic mobility - limbs, prosthetics, osseo integration, balance, gait and poise
- Brain-computer interfaces (BCI) or neural links –limbs, muscular system and organs
- Artificial organs (and AI-enabled organ software)
- Deep Brain Stimulation treatments
- Neuromodulation
- Bio-sensors
- Nano-bionics
- Bio-fabrication – prosthetics, organs, tissue
- Wearables (aligned to bionic solutions)
- Enabling technologies (AI, machine Learning, robotics, quantum computing, AR/VR, other)
Which category are you applying for?
- Category 1 - Sector Leaders
- Category 2 - Innovators, Scientists and Small to Medium Enterprises (SMEs)
- Category 3 - small health, education, professional service providers or charities
Annual turnover (to enable Bionics Queensland to determine your annual fee level)*
Confirmation*
- I confirm I have read the Summary of Benefits and Fees for Associates.
Declaration*
- Declaration: By submitting this form you are confirming that you wish to become an Associate of Bionics Queensland Incorporated and that you agree to be bound by the policies and rules of the organisation in place at the present time.
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Name
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We will discover, innovate and achieve more with you involved!

How to become a Bionics Queensland Associate

Application form

Company Details

Representative Details

Other Representative Details

Additional Details