Membership Form Aarnja Ltd

Name:

Home Number: Mobile Number:

Postal address:

Residential Address:

Email: Date of Birth:

• Please note only Kimberley Aboriginal people may apply.

I would like to become a member of Aarnja Limited.

I am a...... (Please see back of this page for further info and insert claim group or community) person; and

I identify with the ...... (insert cultural bloc, please see back of page).

Signed:

Witness:

Date:

FOR OFFICE USE ONLY

Date Received: Registration Number:

Date Accepted: Signed by:

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Photography Consent Form Aarnja Limited

Please read the below carefully, then sign and date this form to consent to its contents. Aarnja is seeking your consent to use and publish your name and the photographs and/or images of you, including for promotional, information or reporting purposes. When giving your consent you should be aware that the information, photographs and/or images may be published on the internet and may be copied and used by any web or other user and that Aarnja will have no control over its subsequent use and disclosure. You acknowledge that you will not be entitled to any remuneration for the use of such information, photographs, images and/or testimonial(s) by Aarnja. I ...... (print name) consent to Aarnja (itself or jointly with others) publishing information, photographs and/or images taken of me in any Aarnja publication or advertisement (in various formats including cinema, television, newspaper, online advertising and outdoor advertising, and publications made by Aarnja itself or jointly with others), electronic and hard copy publications, Aarnja-related websites and social media sites and in any other similar ways deemed appropriate by Aarnja.

Signature

Date

East Kimberley Miriuwung Gajerrong, Lumugal, Kija (includes: Ngarrawanji, Purnululu, Malarngowem, Yurriyangem Taam), Jaru (includes Koongie-Elvire) and Lamboo.

Central Kimberley Kurungal, , , Noonkanbah, and the unclaimed areas between claims

West Bardi Jawi, Mayala, Nyul Nyul, Goolarabooloo-, Djabera-Djabera, Warwa (Mawajala Gadjidgar and unclaimed Warwa area), (ie Rubibi), and the unclaimed central peninsula area

Desert Tjurabalan, (ie Parts A, B, and C, Yi-Martuwarra), , Yawinya, Nyikina Mangala (including unclaimed Nyikina Mangala Country).

North Kimberley Wanjina Wunggurr Wilinggin, Wanjina Wunggurr Dambimangari, Wanjina Wunggurr Uunguu (includes part B), Balangarra (includes combined and #3).

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