Membership Application


If you are interested in becoming a CCSA please fill in the online form below. Or if you would prefer, download and complete the printed form.

Printed Membership Form

APPLICATION FOR MEMBERSHIP



Personal Details


Preferred Address


This is your preferred mailing address. Note that all correspondence will be forwarded to this address.


Postal Address


This is an alternate address which will be used if attempts to forward mail to you at your primary address fail.


Type of Membership

(Applications for student membership need to be accompanied by proof of current enrolment in a recognised HIM / Clinical Coder education course)


RELEASE OF DETAILS**


I do not wish the Managing Committee of the CCSA to release my address details to organisations or companies approved by the Committee for distribution of relevant material, newsletters or advertising. I undertake to notify the CCSA in writing at such time as I wish to begin receiving advertising material.


Agreement


I understand that by joining the CCSA I agree to be bound by the Code of Ethics and Constitution of the Clinical Coders’ Society of Australia Inc.


Payment


Upon review of application you will be invoiced for your membership by CCSOFA

APPLICATION FOR MEMBERSHIP



Personal Details


Preferred Address


This is your preferred mailing address. Note that all correspondence will be forwarded to this address.


Alternate Address


This is an alternate address which will be used if attempts to forward mail to you at your primary address fail.


Type of Membership

(Applications for student membership need to be accompanied by proof of current enrolment in a recognised HIM / Clinical Coder education course)


RELEASE OF DETAILS**


I do not wish the Managing Committee of the CCSA to release my address details to organisations or companies approved by the Committee for distribution of relevant material, newsletters or advertising. I undertake to notify the CCSA in writing at such time as I wish to begin receiving advertising material.


Agreement


I understand that by joining the CCSA I agree to be bound by the Code of Ethics and Constitution of the Clinical Coders’ Society of Australia Inc.


Payment


Upon review of application you will be invoiced for your membership by CCSOFA