Life Membership

ATDC Life Membership

The Alcohol, Tobacco and other Drugs Council life membership is awarded to individuals acknowledged by the Council to have rendered outstanding service to the Council and/or the ATOD sector over a long period of time.

Criteria

Life members are individuals acknowledged by Council to have rendered outstanding service to Council and/or the ATOD sector over a long period of time. Life membership shall be granted only by a General Meeting on the express recommendation of the Board.

How to apply

If your nominee meets the criteria, please complete and submit the form below. You can also download an application form to submit by email or post.

Life Membership Application

1 Nominee

2 Nomination

3 Nominator

4 Referees

Nominee
Who are you nominating for ATDC Life Membership?
Name*
First Last
Position title and organisation
Preferred contact address*
- Email
- Post
Email*
Enter Email Confirm Email
Postal address*
Street Address Address Line 2 City State / Territory Post Code
Phone*
Mobile*

Details of nomination
Outstanding service*
How has the nominee given outstanding service to the Council and/or the ATOD sector over a long period of time?
Examples*
Please give examples of the nominee's extraordinary expertise, dedication and positive influence to the Council and/or the ATOD sector.

Nominator
Please provide your details below.
Name*
First Last
Position title and organisation
Email*
Enter Email Confirm Email
Phone*
Mobile*

Referee 1
Name*
First Last
Position title and organisation
Preferred contact address*
- Email
- Post
Email*
Enter Email Confirm Email
Postal Address*
Street Address Address Line 2 City State / Territory Post Code
Phone*
Mobile*
Referee 2
Name*
First Last
Position title and organisation
Preferred contact address*
- Email
- Post
Email*
Enter Email Confirm Email
Postal Address*
Street Address Address Line 2 City State / Territory Post Code
Phone*
Mobile*
CAPTCHA

ATDC Life Membership

Criteria

How to apply

Life Membership Application

Nominee

Details of nomination

Nominator

Referee 1

Referee 2

Traditional Custodians.

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