Apply Without a Referral

Apply for membership

As we're expanding our membership, if you haven't been referred and wish to join, please complete the form below and our team will be in touch.

Full name*

Email address*

Tell us about yourself*

Why do you want to join Conneq?*

Instagram or Facebook name

Optional, but it helps our team verify who you are before we follow up. A username is fine — you don't need a link.

I confirm that I am 18 years of age or older.*

Conneq membership is only open to those aged 18 and over.

I have read and agree to the Conneq Terms & Conditions.*

You must accept the Terms & Conditions to apply.

Know a member who can refer you instead? Apply with a referral

Thanks for applying