	Families and Friends for Drug Law Reform
	committed to preventing tragedy that arises from illicit drug use

Membership

Families and Friends for Drug Law Reform recognise that prohibition laws have failed to keep illicit drugs from harming our families and friends. We therefore want to encourage the implementation of policies that reduce the health and social harm that illicit drugs cause.
Help make a difference - Join the Families and Friends for Drug Law Reform

Please complete this form and mail to the address below. (Fields marked '*' are required fields)

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*First name					*Last name
*Address
*City
*State		*Post code
*Email			Home Phone
Work Phone			FAX
Annual membership (single or family)	$15 Ordinary $5 Concession (Concession includes pensioner, student, unemployed)			Any additional donation would be most appreciated.
Payment instructions	Please print and mail the completed form with a cheque or stamps to the address shown below.
*Payment method	Cheque Postage stamps
Comments or details of other family members

A receipt will be provided.

Mail address

Families and Friends for Drug Law Reform (ACT) Inc.
PO Box 4736
HIGGINS ACT 2615

Enquiries: PHONE: (02) 6254 2961