Membership Form

  • 1. Please provide the following personal information:

  • The following questions pertain to organisations. If you are applying to become a Supporter, please go to question 11.
  • 7. Organisation's contact information:

  • 8. Key contact person at your organisation:

  • The following questions pertain to individuals. If you are applying as an organisation, please go to the end of the form.
  • Thank you for your application. It will be reviewed by the CLLAN Steering Committee at the next scheduled meeting. You will be contacted if there are questions about your application and informed of the decision on your membership once it has been made. If you have any questions, comments or concerns, please list them here or email us at info@CLLAdvocates.net.