Name *

First Name

Last Name

Phone *

(###)

###

####

Payment Method

Please tick one

PayPal

EFT

Money order

Cheque

I currently practice *

Please tick one or more

No

Wushu

Tai Chi

Qigong

I have read and agree to the terms and conditions *

Yes

I am seeking cover by WTQA Class Exemption to practice, possess or carry a Wushu or Tai Chi sword

Please tick Yes or No

Yes

No

I have read, the permissions, purposes and conditions of the Governor in Council (GIC) Order covering the activities involving swords as set out in pages 3 and 4 of this application

See link below the next question

Yes (for class exemption applicants only)

I agree to comply with the GIC Order requirements, as evidenced by ticking this box below

Yes (for class exemption applicants only)

Option 1: I have sent a statutory declaration stating that I am not a Prohibited Person as defined and as required by the GIC Order? (tick)

You can chose this option or the one below, you don't need both. Please send documents to membership@wtqa.org.au or Wushu Tai Chi and Qigong Australia Inc. PO Box 246, Ashburton Victoria 3147

Yes (for class exemption applicants only)

I have previously submitted my statutory declaration (for class exemption applicants only) (Renewals only)

Option 2: I have sent a Police Check verifying that I am not a Prohibited Person? (tick)

You can chose this option or the one below, you don't need both. Please send documents to membership@wtqa.org.au or Wushu Tai Chi and Qigong Australia Inc. PO Box 246, Ashburton Victoria 3147

Yes (for class exemption applicants only)

I have previously submitted my Police check (for class exemption applications only)(Renewals only)

I hereby certify that the information provided by me in this application is true and correct.

Please tick

Yes