Online Application

Your Given Name*

Your Surname*

Male Female 

Date of Birth*

Postal Address*

Suburb*

State
- Select -ACTNSWNTQLDSATASVICWA

Postcode*

Country

Mobile Phone*

Your Email*

Employer*
- Select -Virgin AustraliaVARATigerair

Employment*
- Select -Full TimePT75PT50RORO

Base*
- Select -BNEMELPERSYDCBR

Fleet*
- Select -B737B777A330A320ATR72F100

Rank*
- Select -CaptainFirst OfficerSecond Officer

VA Wide Body, VA Narrow Body FO or Tigerair FO Salary Level
- Select -Level 1Level 2Level 3

VARA Only - Year of Service
- Select -Year 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10

Staff Number*

Referring Member - a current VIPA member who referred you to VIPA

Payment*
Membership fees can be paid annually in full or by a regular direct debit. You will be emailed an invoice for pro rata annual payment or a direct debit invoice for your records. Direct debits are managed by Ezidebit who charge a service fee. An electronic direct debit authority will be emailed to you to set up the direct debit.
- Select -Invoiced AnnuallyDirect Debit Monthly - 1st or 5th of each monthDirect Debit Quarterly - 15 Jul, Oct, Jan and AprDirect Debit 4weekly - coincide with VA Overtime pays

VIPA Loss of Licence Fund - VLF*
I understand that to join the VLF I will need to complete a VLF Application Form and Health Questionnaire. I will need to submit both of these forms before protection is offered.
 YES I would like to join VLF NO I decline protection at this time

After you submit this application, you can complete the online VLF Application Form and VLF Health Questionnaire.

By clicking Submit you indicate you have accepted the Terms and Conditions below:

1. I am employed as a pilot, on airline services within or extending beyond Australia, by Virgin Australia Group or any subsidiary related body corporate or associated entities, its successors, transmittee or assignee.

2. I agree to abide by the rules of VIPA (the “rules”) as amended from time to time.

3. I understand that I remain a member of VIPA until I revoke my membership in writing in accordance with the rules and with the Fair Work Act 2009.

4. I agree to pay annual subscription fees in accordance with the rules and that the annual subscription fee of VIPA is 0.99% of my annual gross salary as amended from time to time.

5. I have read the information supplied relating to financial obligations of membership and the circumstance and manner in which I may resign my membership.

6. I understand that my initial invoice will include a $16.50 admission fee.

7. I agree to advise VIPA by emailing secretary@vipa.asn.au of changes to my employment details including but not limited to: fleet; rank; base and full-time/part-time status, within 3 months of such changes occurring.