Membership Application Form

Become a Member

Become a member

To become a member of LDAA, please fill out the form below. Additionally, if you would like to receive our newsletter please also tick the box next to ‘Yes I would like to receive the LDAA newsletter’ via email.’

If you would like to make a donation, please head to our ‘Donations‘ page.

We value your membership of the Lyme Disease Association of Australia. "Alone we can do so little, together we can do so much." --Helen Keller

Name *

First

Last *

Last

Email *

Any additional information

Gender *

Male

Female

Other

Date of Birth

Phone Number (mobile or best contact) *

Phone Number (alternate)

Code of Honour Agreement *

I Agree

Code of Honour

Purpose for Code: 
To support leadership by fostering an environment of genuine collaboration acceptance and kindness in which all team members feel empowered to express their individual and collective potential.
To connect the LDAA community in common values and purpose to achieve the highest level of outcomes in awareness and action for the whole Lyme-like community.
I agree to:
	keep my communications focussed on the aims of this group
	communicate with kindness and integrity, listen openly, and honour one another including our differences
	speak up and let go! (Your idea may not be the final outcome, but could be integral in supporting the best possible outcome. Going for the highest thought!)
	foster and support ethical, board and community behaviour and relationships, treat all stakeholders  (government, health professionals, Lyme community) respectfully like part of our team
	keep a long-term vision and my eye on the goal, rise above the ‘little’ things / setbacks
	keep all agreements and communicate immediately when unable to do so
	celebrate all wins and help community celebrate wins
	be coachable; there’s always new things to learn at any age
	be responsible to ask for help when needed
	speak directly to the person who can take action when I have an upset (ie: not speak behind anyone's back or support 'complaining' or 'gossip' within the team or greater Lyme-like community). Go directly to the person or alternatively a board member should you need assistance.

If you have an upset that’s very emotive for you, then ‘vent/debrief’ privately (by phone or private message) with a mature/responsible individual who understands they’re just there to listen, not take sides and aware that there’s always two sides to every story. Then, commit to move on, let it go, and relate responsibly.
Regarding Social Media: Healthy debate is an important aspect of any activism – when it becomes heated or verbally abusive, a group admin may have to step in and stop or delete the thread.

All members receive the LDAA Newsletter *

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4 thoughts on “Membership Application Form”

Civil Marriage Celebrant Sydney Australia August 14, 2011 at 10:01 am

Please can you link to our sites http://www.sarcoidosisaustralia.com and http://www.sarcoidosis-sarcoid.com

Reply ↓
1. lymediseaseaustralia August 28, 2011 at 2:46 pm
  
  Hi, we’ve added a link to both your sites here – http://lymedisease.org.au/resources/ we hope you find it useful. I love your logo by the way, it is very funky.
  
  Cheers
  
  Nikki
  
  Reply ↓
Jeni Taylor April 20, 2014 at 1:22 pm

I would like to hold a fundraising activity for Lyme disease. Can you provide me with flyers and information please? I have been unsuccessful in printing the flyer from the website.

Reply ↓
1. Sharon Whiteman April 21, 2014 at 12:20 pm
  
  hi Jeni, We have emailed you Regards Michelle Kelly
  
  Reply ↓

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4 thoughts on “Membership Application Form”

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