CPCA Membership Application (Prompt)

By completing the online application form you are applying for Corresponding Membership of the CPCA. For more information about the higher levels of membership, please review How to become a CPCA Full Member and How to become a CPCA Fellow.
Membership fees start from $825.00 per annum, GST Inclusive, payable upon application.

You will need:

  1. Your AHPRA or MCNZ Medical Registration Number.
  2. Copy of Drivers Licence or Passport.
  3. A head & shoulders photograph (don’t go to any trouble).
  4. To pay via credit card.  $825 incl. GST.
  • Type of Applicant

  • Please select ONE from the list below:
  • Select an option from the drop-down list below.
  • Applicant's Details

    Personal details must match the record contained within AHPRA Medical Register. Click HERE to check.
  • PRIMARY CONTACT DETAILS

    These details are NOT published anywhere. Once you activate your login to the member website area, you will be able to update your public profile for use with the Find-a-Doctor website section (Full Members & Fellows only).
  • If applicable.
  • Accepted file types: jpg, png, pdf, gif, Max. file size: 5 MB.
  • Processing of application may be delayed where this is missing. Do not go to any expense. This image will NOT be published anywhere.
    Accepted file types: jpg, png, pdf, gif, Max. file size: 5 MB.
  • MEMBERSHIP FEE PAYMENT - $825.00

    Receipt and paid tax invoice will be provided via return email.
     

    Credit Card Payment

    Visa or Mastercard only. American Express is not accepted.
    Please provide card details below.
  • $825 + $14.85 = $839.85 Inclusive of GST
    Price: $ 839.85
  • Membership fee + credit card payment fee
    $ 0.00
  • Applicant's Declaration

    Please read the declaration you are making below. Tick all boxes to acknowledge you have read and accept the terms.
  • DD slash MM slash YYYY
  • Please note: It is unlawful to knowingly make a false declaration and is an offence which carries
    significant penalty if prosecuted. In particular, but not exclusive to:

    - *Health Practitioners National Law Act (2010 Commonwealth),
    - Medical Board of Australia: Good medicine: a guide for doctors in Australia,
    - Medical Board Australia: Advertising Guidelines,
    - Medical Board of Australia: Guidelines for doctors performing cosmetic medicine and surgery,
    - Medical Board of Australia: Technology Based Consultations,
    - Local State and/or Territory Laws (Relevant Poisons Acts in the principality of your practice),
    - Therapeutic Goods Act (Commonwealth)

    Click here to view the Membership Information Booklet. Includes a copy of the College Constitution, Policies & Guidelines.
     
    Your application is subject to approval/acceptance by the Membership Committee. Processing may take up to one business day. A tax invoice/receipt and welcome package will be sent via email. Thank you.
  • Please ensure that you have answered all the required fields and uploaded all the required documents before clicking the "Submit" button.