APPLICATION TO BECOME A MEMBER OF THE FAR NORTH ALCOHOL AND DRUG CENTRE
I ..............................................................ID number:.................................................
Postal address:..........................................................Tel:........................................... hereby wish to apply for membership of the above Organisation.
I would like to become a:
Active member
Donor member
(See attached Constitution for the description of Active and Donor member)
I undertake:
1. To pay in advance, a yearly membership fee of ......................... for the period of one year (active members only)
or
(donor members only)....................................... once off payment/ debit order payment. (please indicate once off or debit order payments)
2. To remain loyal to the interest and ethical principles of the Organisation
3. To inform the Organisation of changes of address.
4. Donor members will receive a certificate as proof of membership status after payment is received.
The Far North Alcohol and Drug Centre undertake:
1. To remain loyal to the interest and ethical principles of the Organisation
2. To keep you informed on activities by the Organisation, either by e-mail or mail.
3. To send a newsletter at least twice a year in order to keep you informed on substance abuse trends and trainings.
4. To invite you to training sessions, organized by the Organisation and applicable to the public.
5. Invite you to our Annual General Meeting.
All information on the form will be handled as confidential. All members will be put on a register, that will be reviewed annually.
SIGNATURE: ...........................................................
DATE: ......................................................................
Please fax the completed application form and proof of payment to (015) 291 2709
NOTE: No amount is set to become a donor member, donor members can decide on the amount they would like to donate to become a donor member.