APSU Member Signup - Sharc APSU

First name

Last name

Email

Mobile

Year of birth

1. Where are you located?

Greater Melbourne

Regional Victoria

Interstate or overseas

2. What is your postcode?

3. I understand that all personal information obtained by SHARC will be kept confidential and used only for the purposes outlined in the privacy policy. Click here to read our privacy policy.

All personal details obtained by APSU will be kept confidential and only used for the purposes outlined above.

4. Gender Identity

Female

Male

Trans Female

Trans Male

Non-binary

Gender diverse

Prefer not to say

5. I prefer to self specify

6. Self-specify

7. What pronouns do you use?

she/her

he/him

they/them

I would prefer not to say

8. I would prefer to specify my pronouns

9. Do you identify as Aboriginal and Torres Strait Islander?

Yes

No

10. Do you identify as part of the LGBTIQA+ community?

Yes

No

Prefer not to say

11. Do you identify as neurodivergent?

Yes

No

Prefer not to say

12. Are you part of a multicultural or faith-based community?

Yes

No

13. Do you speak a language other than English with your family and friends?

Yes

No

14. Please specify what language/s you speak with your family and friends

15. Do you identify as living with a disability?

Yes

No

Prefer not to say

16. How would you describe your lived or living experience?

(Please select all that apply.)

Lived or living experience of alcohol and / or drug use (AOD)

Lived or living experience of mental health concerns

Lived or living experience of problems with gambling

None of the above

17. How would you describe your relationship with alcohol and other drugs, and/or mental health services? (Please select all that apply)

I am a current or past consumer of AOD services

I am a current or past consumer of mental health and wellbeing services

I am a family member / partner / carer

I work or volunteer in an AOD, mental health and wellbeing, or allied service

18. What year did you last use an AOD service?

19. What year did you last use a mental health service?

20. What year did the person you support last use an AOD or mental health service?

21. What year did you last work or volunteer in an AOD, mental health and wellbeing, or allied service?

22. Would you like to receive a copy of Flipside magazine?

Flipside is a publication by and for consumers. APSU members can contribute their articles, stories, poetry, artwork, or designs. (Select your preference)

Yes, electronic copy

Yes, paper copy

No, I don’t want to receive Flipside

23. Please select all areas from the list below that you would like to receive emails about.

Consumer and family participation, and consultancy activities. 

Receive invitations to participate in paid opportunities including focus groups, consumer advisory groups and co-design workshops.

Training sessions for consumer and family participation.

Find out more about training to support consumer and family participation, and when the next sessions are being held.

Speaker Bureau.

Help raise awareness, overcome stigma and shame, and educate people about drug use, recovery and hope by telling your story. Join to find out about speaker training and upcoming speaker events.

Issues and information relating to AOD services and policy.

Stay up to date and receive regular emails about AOD services and policy, drug alerts, employment opportunities and other updates about the AOD community.

24. Please share with us why you want to join APSU