Laryngectomee Association of NSW Inc.
Membership Application Form

Membership is open to laryngectomees or persons with a similar communication disability,
partners, carers, doctors, and allied health professionals. 

Membership Benefits

  • FREE Welcome Pack - toiletry bag, vanity mirror, forceps, stoma cover, personal light, stoma wipes, emergency car window sticker, emergency seatbelt cover, emergency wristband, a pen, emergency neck breather wallet card, General Information and First Aid leaflet, ‘You Can Say That Again’ booklet.

  • LaryLink - access to our private online community group - connect with laryngectomees across NSW and beyond.

  • News Updates - on the activities of the association via LaryLink, email news updates, Facebook and LinkedIn.

  • Invitations to association events and functions.

  • Shop- purchase laryngectomee supplies at cost or discounted, plus free postage for members.

  • Support Meetings - in Sydney, Newcastle and regional NSW.

Membership Fees

Membership Joining fee: $10
Membership annual renewal: $10, due 1st January.

When your application is approved, we'll send you an email with a link to pay your joining fee.
 
Please Note: Membership is only valid when we receive payment. 

Your Details

Gender Identity (optional)
  • Male
  • Female
  • Non-binary
  • Other
  • Prefer not to disclose
  • No elements found. Consider changing the search query.
  • List is empty.

Street Address

State or Territory (required)
  • NSW
  • ACT
  • NT
  • QLD
  • SA
  • VIC
  • WA
  • No elements found. Consider changing the search query.
  • List is empty.

About You

Where did you have your laryngectomy?
  • Canberra
  • Chris O'Brien Lifehouse
  • Dubbo
  • Gosford
  • John Hunter
  • Liverpool
  • Prince of Wales
  • Royal North Shore
  • Royal Prince Alfred
  • St Georges Private
  • St Georges Public
  • St Vincents Private
  • St Vincents Public
  • Westmead
  • Wollongong
  • Other
  • No elements found. Consider changing the search query.
  • List is empty.

No email address? 

If you do not have an email address, you can submit your application by post.
Click HERE to download the the postal application form. 

To complete your application, tick 'I agree to the LANSW Terms and Conditions' and 'I am not a robot' box. then click on the 'Submit Application' button to submit your application.  

*I agree to the LANSW Terms and Conditions.

THE LARYNGECTOMEE ASSOCIATION OF NEW SOUTH WALES INCORPORATED - REGISTERED CHARITY

PO Box 443, Woy Woy, NSW 2256. Registered Charity | ABN 48 862 877 872

Terms & Conditions