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Expressions of Interest for membership of the Australian Medical Research Advisory Board (AMRAB)
Page 1 of 6
Closes
9 Nov 2025
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Personal Details
Gender
How do you describe your gender?
(Required)
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Man or male
Woman or female
Non-binary
I use a different term
Prefer not to say
Title
Title
(Required)
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Mr
Mrs
Miss
Ms
Sir
Reverend
Lady
Doctor
Professor
Honorary
Sister
Associate Professor
First Name
First Name
(Required)
Preferred Name
Preferred First Name
Last Name
Surname
(Required)
Residential Address
Residential Address
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State
State
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ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Other
Preferred contact number
Phone number
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Citizenship
Please indicate your Australian Residency Status:
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Australian Citizen
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