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Member Login
Registration
Please fill out the form below to register for membership of Gay & Lesbian Equality (WA).

Your image will be resized if needed to a maximum dimension of 100 pixels width x 250 height automatically, but your image file should not exceed 2000 KB.

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By clicking "Register", you certify that you have the right to distribute this photo and that it does not violate the Terms and Conditions.
* This Field is required Information for: First Name : Please enter your real first name.
Information for: Middle Name : Please enter your real middle name.
* This Field is required Information for: Last Name : Please enter your real last name.
* This Field is required Information for: Email : Please enter a valid e-mail address. A confirmation email will be sent to this address upon registration.
Information for: Phone Number : A phone number via which GALE(WA) can contact you about urgent campaign actions. GALE(WA) keeps this information strictly confidential, will treat your phone number with respect, and will only call you if there is an urgent campaign action that needs your help.
* This Field is required Information for: Username : Please enter a valid username. No spaces, at least 3 characters and contain 0-9,a-z,A-Z
* This Field is required Information for: Password : Please enter a valid password. No spaces, at least 6 characters and contain lower and upper-case letters, numbers and special signs
* This Field is required Information for: Verify Password : Please enter a valid password. No spaces, at least 6 characters and contain lower and upper-case letters, numbers and special signs
Information for: Bio : A paragraph telling us a little about yourself
 
* This Field is required
Before registering, you must read and accept the GALE(WA) Membership Agreement / Terms & Conditions. Please take the time to read these, as they outline your commitment to GALE(WA), and our commitment to you as a member.

NOTE: Some users have been experiencing trouble with this form. If you are having trouble with the registration form, email shane@galewa.asn.au who will process your registration manually.