Members

We welcome your support/continued support and subscription to the Australasian Cleft Lip and Palate Association. Please complete the below application form and return to the address overleaf with your cheque (in Australian dollars) or directly deposit the funds into the ACLAPA account (in Australian dollars). Please ensure there is a reference with the deposit, preferably your full name. A receipt will be issued. Please indicate in the section below if you do not wish to have your details appear in the membership directory.