Ambassador Membership Application

It is a relatively easy process to become an Ambassador of HelpStop, however to abide by our constitution four things must be completed.

Fill out the application form provided by HelpStop. The application should include your contact details, your reasons for applying
By submitting an application you agree to have read and understood HelpStop's constitution, privacy policy, Non Conduit policy and code of conduct.
Once your application is processed and approved, you will be issued a certificate of Ambassador membership. This certificate will include your unique membership number and will be sent to you via email.
After receiving your membership certificate, the Customer care team will get in touch with you. They will discuss how you wish to be involved with HelpStop and provide suggestions on how you can assist them in their efforts to mitigate the harm caused by gambling.

Ambassadors are specialised members that directly assist the marketing team in the promotion of HelpStop within the wider community. This may include:

Holding luncheons etc. for invited guests to hear about our harm prevention program
Be the master of ceremony at a charity ball or other fundraising events
Use your own platform, twitter, linkedin etc. to promote HelpStop.

Please Fill In All Required Fields

First Name: *

Middle Name:

Last Name:

Address:

Landline:

Mobile Number:

Email:

Date of Birth: *

I wish to become a Ambassador of HelpStop because: *

How I can be of assistance to HelpStop:

I have experience in the following areas:

Date of Application: *

Signature: *

References to Fill Out

First Reference

Reference's Full Name: *

Reference's Number: *

Reference's Email: *

Relationship to Yourself: *

Second Reference

Reference's Full Name: *

Reference's Number: *

Reference's Email: *

Relationship to Yourself: *

Third Reference

Reference's Full Name: *

Reference's Number: *

Reference's Email: *

Relationship to Yourself: *

HP: