Membership Application Form Your membership application will be considered by the Board. If accepted you will be registered as a member. Name(Required)Address(Required)Email(Required) Telephone No(Required)D.O.B(Required) MM slash DD slash YYYY Gender(Required) Male Female Gender(Required) I am Aboriginal I am Torres Strait Islander I am Both Acknowledgement I would like to receive emails and newsletters from Apunipima Cape York Health Council Ordinary MemberHave historical or Traditional connection to the community of: Aurukun Coen Hope Vale Injinoo Kowanyama Lockhart River Mossman Gorge New Mapoon Seisia Wujal Wujal Bamaga Cooktown Horn Island Weipa Laura Mapoon Napranum Pormpuraaw Umagico Other Associate Member I do not have a Traditional or Historical connection to Cape York Peninsula SignatureDate(Required) MM slash DD slash YYYY More About Apunipima The Apunipima Way Our Communities About Apunipima