Application for Membership - Pharmacy Guild of Australia

To submit your completed application form to The Pharmacy Guild of Australia, Queensland Branch, choose one of the following methods: Email to membership@qldguild.org.au, Fax to 07 3831 9246, or Mail to PO Box 457, Spring Hill, QLD 4004. Ensure all details are completed and accurate before submission. It is recommended to keep a copy for your records. Check for any additional documents required and attach them if necessary. For any queries, contact the Queensland Branch at P +61 7 3831 3788. Submit promptly to avoid delays in your membership application processing.

Please refer to The Pharmacy Guild of Australia for specific dates related to membership application submissions for 2024 and 2025.

The purpose of this form is to facilitate the application process for membership with The Pharmacy Guild of Australia, Queensland Branch. By completing this form, sole proprietors, partnerships, and company directors can register their pharmacies as members of the Guild. Becoming a member provides access to resources, support, and advocacy for community pharmacies. This form requires detailed information about the applicant's personal details, their pharmacy or pharmacies, and the nature of their proprietorship. Accurate information is crucial for the Guild to process the application effectively. Members agree to be bound by the Guild's Constitution and Resolutions and to adhere to its obligations, including the payment of subscription levies and other fees. Submission of this form also implies consent for the use and disclosure of personal information in accordance with the Guild's privacy policy.

• 1. Title: Select the appropriate title (Mr, Mrs, Miss, Ms, Other) of the applicant.
• 2. Surname: Enter the applicant's surname.
• 3. First name: Enter the applicant's first name.
• 4. Middle name: Enter the applicant's middle name (if any).
• 5. Preferred name: Enter the preferred name.
• 6. Gender: Select the applicant's gender (Male, Female).
• 7. Date of birth: Enter the applicant's date of birth.
• 8. Mobile phone: Enter the applicant's mobile phone number.
• 9. Private phone: Enter the applicant's private phone number.
• 10. Private email: Enter the applicant's private email address.
• 11. Private address: Enter the applicant's private address.
• 12. Postal address: Enter the postal address if different from the private address.
• 13. Pharmacy name: Enter the name of the pharmacy applying for membership.
• 14. Pharmacy street address: Enter the pharmacy's street address.
• 15. Pharmacy postal name & address: Enter the pharmacy's postal name and address if different.
• 16. Pharmacy email: Enter the pharmacy's email address.
• 17. Phone: Enter the pharmacy's phone number.
• 18. PBS Approval Number: Enter the PBS approval number of the pharmacy.
• 19. Banner name: Enter the banner name of the pharmacy.
• 20. Nominee: Complete Form 13 for nominee appointment and submit along with this form.

Failure to submit this form may result in the applicant's inability to become a member of The Pharmacy Guild of Australia. This means missing out on member benefits and support services provided by the Guild.

• Missed Membership Benefits: Applications not submitted will miss out on the benefits and support services provided by the Guild to its members.
• Non-compliance: Failure to comply with the Guild's membership requirements may impact the applicant's professional standing.

• 1. New Membership Applications: Individuals seeking to become first-time members of The Pharmacy Guild of Australia.
• 2. Renewal Applications: Existing members renewing their membership for another term.
• 3. Pharmacy Ownership Changes: New owners of pharmacies registering for Guild membership after acquisition.
• 4. Multi-Pharmacy Registration: Owners responsible for more than one pharmacy who need to register each pharmacy.
• 5. Nominee Appointments: Individuals appointed as nominees under Rule 7 (b)(i) should complete this form alongside Form 13.