Apply for membership

Membership application

Let’s get to know you

Fields marked are required.

Personal details

Given name

Family name

Email address

Phone number

Suburb / city and state

For example, Gungahlin, ACT.

Professional details

Specialty / area of practice Optional

Practice / hospital Optional

AHPRA registration number Optional

If applicable: MED followed by 10 digits. This is supplied for executive review; no automatic register check is performed.

Anything you’d like us to know? Optional

Please do not include patient information or sensitive medical details.

How we use your information

Your application is stored for review by authorised NAMDA executives and administration of your membership application. It is not a public directory entry. No payment details are collected here.

I confirm that I am a doctor of Nigerian descent with a connection to the ACT or surrounding region. The details I have provided are accurate. I understand how this application will be used, and that membership requires executive approval and payment of dues.

Please submit once. If you have already applied, another submission will not create a second application.