Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Mobile and/or local number with area code

(###)

###

####

Date of Birth *

MM

DD

YYYY

Gender *

Male

Female

Other

I currently practise:

Wushu

Tai Chi

Qigong

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

Yes

No (If no, please return to the Individual Membership page and fill out the application form without class exemption.)

I have read the permissions, purposes and conditions of the Governor in Council (GIC) Order covering the activities involving swords.

Yes

I am not a Prohibited Person as defined and as required by the GIC Order.

Please select which document you will provide WTQA as confirmation.

Statutory Declaration

Police Check

REQUIRED DOCUMENTATION: Please email the following forms to membership@wtqa.org.au and tick the boxes when complete.

Signed GIC requirements for a weapons exemption (including your initials on each page).

Statutory Declaration or Police Check - Prohibited Persons declaration.

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

Yes