Child Injury Prevention Network Child Injury Prevention Network Membership Child Injury Prevention Network
Child Injury Prevention Network Child Injury Prevention Network Child Injury Prevention Network Child Injury Prevention Network
Child Injury Prevention Network
Child Injury Prevention Network Child Injury Prevention Network Child Injury Prevention Network Child Injury Prevention Network
Child Injury Prevention Network
Child Injury Prevention Network
Child Injury Prevention Network
Child Injury Prevention Network
Child Injury Prevention Network
Child Injury Prevention Network

Membership enquiry

To become a CIPN Member or to request more information about the Child Injury Prevention Network please complete the following...

Organisation Name
Contact Details:
Street and Number:
Town/City/Surburb:
State/Region:
Country:
Post/Zip Code:
Phone Number:
Email Address:
Website Address:
Contact Person:
Name:
Role/Position:
Contact Details:
(if different to above)
Organisation Details:
Summary of Organisation's Business Activities (Role/Mission/History/Past Programs, Issues & Successes)
 
Interest/Issues your organisation has in Child Safety
Alcohol &/Drugs   Travel Safety
Intentional Injuries   Suicide Prevention
Falls   Seasonal Safety
Water Safety   Rural/Farm Safety
School Safety   Scalds & Burns
Home Safety   Advocacy
Fire Safety   Product Safety
First Aid   Playground Safety
Road Safety
Other (please specify):
 
What would support your program/s or work in the area of Child Injury Prevention?
Information on Current Programs   Research/Surveillance
Access to Child Injury Data   Child Injury Prevention Contact List
Community Grants/Funding Information   Past Interventions (Sucessful/Unsucessful)
Policies/Procedures   References on Specific Injury Topics
Media Contacts   Advisory Service
Legislation/Standards   Child Development Information
Evidence Based Strategies   Calendar of Child Injury Prevention Events
Human Resources (ie. Volunteers, Expertise, Instructors, Assessment)
Other (please specify):
 
Is your organisation able to contribute information to the Child Injury Prevention Network, where appropriate?
Yes   No
 
Please identify your preferred means of Communication (please supply details if different to above)
Email
Telephone
Post
 
Are there other organisations, community or industry groups that you know of who would be interested in being part of the network?
Child Injury Prevention Network Child Injury Prevention Network