Lyme Disease Association of Australia

Membership Application Form


Become a member

To become a member of LDAA, please fill out the form below. It would be greatly appreciated if you can take a few mins to answer the 'Optional Survey Questions' at the bottom of the form (should take less than 3 min to complete). Additionally, if you would like to receive our newsletter please also tick the box next to 'Yes, I want to receive updates via email.'

Registration Options
Create Profile
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Additional Info










Optional Survey Questions

  

  

  







  


  

  





  

Security Verification
Complete Registration

Thank you, we deeply appreciate your contribution to Lyme awareness in Australia.

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4 thoughts on “Membership Application Form

  1. Jeni Taylor

    I would like to hold a fundraising activity for Lyme disease. Can you provide me with flyers and information please? I have been unsuccessful in printing the flyer from the website.

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