STA Membership Application

STA Members support the aims set out in the STA Charter. Individuals are encouraged to seek the support of their service or organisation to enable information exchange, networking and policy development to take place. Members are free to decide on the depth of their engagement and membership of the STA is provided free by ASH Scotland.

Submission of an application is a declaration of no links to the tobacco industry or its vested interests.

The details you provide will sign you up as a member of the Scottish Tobacco-free Alliance and add you to the associated mailing list. Please refer to the ASH Scotland privacy policy for more information:: www.ashscotland.org.uk/about-us/privacy-and-cookies-policy/. We will not pass your details onto third parties without your permission.
Title *
(Mr, Ms, Dr, Prof)
Your answer
First Name *
Your answer
Last Name *
Your answer
Designation *
(Job Title)
Your answer
Organisation / Service / Institution *
Your answer
Address *
Your answer
Postcode *
Your answer
Email *
Your answer
Telephone *
Your answer
Alternative Telephone
Your answer
Organisation Website
Your answer
In which health board area is your work situated?
If national please state 'national'
Your answer
Indicate the group that most closely identifies with your organisation *
If other, please specify:
Your answer
If your authority, service, organisation or professional body has given you authority to represent their interests at STA meetings, please identify the body here:
Your answer
If you can secure the use of meeting rooms or other help in kind please describe the resources here:
Your answer
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