Membership Application Form

Type of Membership

Please see above for further information on membership, the costs and benefits

Type of Membership I am seeking

Full Australian – working as a paid life story professional.
Full International – as above but living outside of Australia.
Allied – editors, printers, publishers etc supporting life story professionals.
Associate – emerging life storyteller not yet eligible for full membership.
Supporter/Friend
Philanthropic contributor

I am currently working as a Life Story Professional

Full Time
Part Time
Sub-contractor

Full Membership

Business Name

Business Website (1)

Business Website (2)

Hidden

Other

Primary Business Service

Books
Film
Audio
Mixed Media
Photographic
Other

My qualifications to support a full membership are:

Books

Audios or Videography

Life Story Writing/Autobiography/Other

Coaching or Mentoring (Please provide 3 client's names and the year the service was provided)

Do you have any other projects, experience or qualifications you wish to list to support your application?

Business Description for website (limit 70 words)

Skills for Public Directory on website

Reference*

Max. file size: 64 MB.

Please provide a written character or professional reference, including the referee’s phone number and email address.

Referee's name*

First Last

Referee's email*

Referee's phone*

Associate Membership

Starting out
Pausing career
Hobby

Hidden

Your website or email address

Hidden

Phone number for website

Hidden

Allied Industry that supports Life Stories

Allied Membership (related registered business and qualifications in field that support Life Stories)

Business Description for website (limit 70 words)

Skills for Public Directory on website

Would you like to be contacted regarding additional advertising with us

Yes
No

Reference*

Max. file size: 64 MB.

Please provide a written character or professional reference, including the referee’s phone number and email address.

Referee's name*

First Last

Referee's email*

Referee's phone*

Supporter/Friend

Supporter/Friend – I am not a Life Story Professional or Vendor but interested in

Just connecting
Donor
Volunteer

Philanthropic contributor

Supporting Membership

Sponsor Membership – Individual or Organisational

Platinum
Gold
Silver

I am interested in being a Philanthropic contributor and/or making a Bequests

Platinum
Gold
Silver

Captcha

I am prepared to abide by the LSA Code of Ethics (ticking Yes is equivalent to your signature that you will abide. Ticking No means you are not eligible for membership of this Association)*

Yes
No

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Comments

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Membership Application Form

Step 1 of 2

Type of Membership

Full Membership

Full Membership

Associate Membership

Allied Industry that supports Life Stories

Allied Industry that supports Life Stories

Supporter/Friend

Philanthropic contributor

Supporting Membership

Captcha

Have any questions?