Member Advisory Group Application form

.chosen-rtl .chosen-search input[type=text]{--wpr-bg-b456a61c-c855-4995-a9da-cf757069ff99:url('https://enhancedlifestyles.com.au/wp-content/plugins/search-filter-pro/public/assets/css/chosen-sprite.png')}.chosen-rtl .chosen-search input[type=text]{--wpr-bg-9dd7e7c3-a762-4fa6-9986-ede934fedf45:url('https://enhancedlifestyles.com.au/wp-content/plugins/search-filter-pro/public/assets/css/chosen-sprite@2x.png')}footer.footer{--wpr-bg-c08dc5f9-1768-4ca5-bff0-3064514e1527:url('https://enhancedlifestyles.com.au/wp-content/media/background/footer-bg.jpg')}.tact-right-sidebar-wrp .offcanvas-cpt-menu .inner-cover{--wpr-bg-5e7f38b6-006b-4e2c-bc8f-a49eda794901:url('https://enhancedlifestyles.com.au/wp-content/media/banner/nav-shape2.png')}.tact-left-sidebar-wrp .inner-cover .sidebar-shape{--wpr-bg-0e77b304-c2a6-4a84-b927-41467c8ee0b5:url('https://enhancedlifestyles.com.au/wp-content/media/background/service-shape.png')}.contact-form .form-field select{--wpr-bg-60487e73-904a-4799-86f5-03c12e30299a:url('https://enhancedlifestyles.com.au/wp-content/themes/threeam-els/assets/images/sort-down-solid.png')}.rll-youtube-player .play{--wpr-bg-58d70c0d-b16c-4420-8e08-c0e042b1bb19:url('https://enhancedlifestyles.com.au/wp-content/plugins/wp-rocket/assets/img/youtube.png')}

Name(Required)

First Last

Email(Required)

Phone number(Required)

Are you always available on a Wednesday at approximately 12pm-2.30pm?(Required)

Member Advisory Group meetings are currently scheduled for the second Wednesday of every other month.

Why are you interested in joining the Member Advisory Group?(Required)

What experience do you have being part of a team or group like the Member Advisory Group?(Required)

What are your best 3 attributes that you would bring to the Member Advisory Group?(Required)

What professional expertise or qualifications can you bring to the Member Advisory Group? For example, have you worked in nursing, customer service or had your own business? If you have studied, please let us know what course you did.(Required)

Would you attend the Member Advisory Group in-person (held at 215 Port Rd, Hindmarsh 5007 SA) or via online video conferencing?(Required)

I'd be able to come to the Member Advisory Group in-person
I would attend via online video conferencing
I'd try to come to the Member Advisory Group in-person, but I may occasionally have to attend via online video conferencing.

If you are planning on attending the Member Advisory Group in-person, would you require assistance with transport? We would offer a maximum $60 cab charge each way to assist you to attend.

Yes, I'd like a cab charge.
No, I wouldn't need a cab charge.

This field is for validation purposes and should be left unchanged.

Member Advisory Group Application form

Get in touch