MND Australia

Register for the National MND Lived Experience Network

Thank you for taking the time to register with the National MND Lived Experience Network. 

Answering the questions below will help MND Australia to process your registration, so you can participate in the National MND Lived Experience Network, and so you can receive relevant information about the network. 

If you need help filling in this form, or have any questions, please feel free to contact: Julie Labra, MND Australia Project Manager at

(please note: this will not affect your ability to participate in the National MND Lived Experience Network)

Privacy Statement
Your personal information is being collected by MND Australia Pty Ltd (ABN 67 122 440 886) (MND Australia, we, us, our) in order to process your application for participation in the National MND Lived Experience Network, so that we may enable you to participate in the Network and so that we can communicate with you about the Network. All information will be managed in accordance with MND Australia’s Privacy Policy

We will not share your information with other parties unless you have provided consent to do so prior.

Please refer to our Privacy Policy for further details about:

  • how you may access and correct the personal or sensitive information that MND Australia holds about you
  • how you may complain about a breach of privacy by MND Australia and how MND Australia will deal with privacy complaints
  • how to contact us if you have any queries in relation to privacy.

If you are completing this form on behalf of another person (for example, if you are the carer of a person living with MND, who is entering information about that person), please ensure that the person is aware of MND Australia’s Privacy Policy; and obtain their consent for their personal information to be collected, used and disclosed in the manner described in this form.

If you do not provide the information requested, we may be unable to process your registration for participation in the Network or send you information about the Network.