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Australian Privacy Connections Network

Yes, I am interested in joining Privacy Connections.

Title_______ First Name __________________________________________ Surname _________________________________________________________


Position _________________________________________________________________________________________________________________________________________


Division _________________________________________________________________________________________________________________________________________


Organisation ______________________________________________________________________________________________________________________________________


Industry Group ____________________________________________________________________________________________________________________________________


Postal address _____________________________________________________________________________________________________________________________________


City/Suburb _______________________________________________________________ State ___________ Postcode _________


Phone ( )________________________________ Fax ( )___________________________


Email address ___________________________________________________________________________________________________________________________

Please list your specific interest areas (eg. database/direct marketing, education, employment, financial services, health, Internet/security/e-commerce, legal services, real estate, etc.) and/or other comments:______________________________________________________________________________________________

___________________________________________________________________________________________________________________________________________________

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Please subscribe me to the PriNet email list to receive regular news from the Office of the Privacy Commissioner.

Please subscribe me to the Office's quarterly e-newsletter, Privacy Matters.

The information on this form will be used by the Office of the Privacy Commissioner to add you to its Privacy Connections network and to the PriNet and Privacy Matters email lists if you have selected them. The information will not be disclosed to any person, body or agency, except where required by law. To obtain more information about the Office's personal information handling procedures, see its privacy policy at www.privacy.gov.au/policy.

PLEASE FAX TO (02) 9284 9666 OR EMAIL TO corporate@privacy.gov.au

For further information, contact the Office of the Privacy Commissioner's Corporate and Public Affairs section on (02) 9284 9800 or email corporate@privacy.gov.au.