Affiliate Member Application Form

Title:

Name

First Name

Last Name

Organisation

Your current role at Organisation

Country where based

Telephone number

Country

(###)

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What are up to 5 keywords for you/your organisation’s primary AVERT-related interests?

Please identify up to 5 current or recent AVERT-focused programs or work you/your organisation has been involved in

Please include approximate year/s of operation for each entry

Please identify (if any) up to 5 publicly available reports, briefing papers, articles or other publications/resources you/your organisation has produced related to AVERT’s areas of focus

What are your/your organisation’s main reasons for wanting to join the AVERT Research Network?

Please tick all that apply

To connect with potential research partners for project development and/or funding bids on AVERT-related topics

To source research expertise relevant to our organisational focus on policy and/or practice related to AVERT issues

To bring community and/or practitioner and/or government knowledge, voices and issues into focus when designing and disseminating AVERT-focused research

To learn more about AVERT-focused research methods, issues and approaches

To keep in touch with new and emerging issues in the field of AVERT research

To contribute to dialogue and debate on key issues related to AVERT topics through participation in seminars, conferences, symposia and other events

Other

Please list up to 5 current or recent research collaborations you’ve had with other academic, community or government partners in an area of AVERT focus

Other, please describe

Please list up to 5 current or recent research, program or policy collaborations with academic, community or government partners in an area of AVERT focus