Register now: Be a Campaign Champion
Together we can really make a difference. Please complete your details below along with a short survey to help us plan our campaign actions over the coming months.

As the campaign progresses we will ask you to undertake a range of activities. You will all have different levels of experience and skills and everyone will have things they can help us with.

We won’t be asking our Champions to do everything at once. The campaign will evolve over time - we will all be on a journey together. The more help you can offer the more powerful our campaign will be.

After you fill out this survey, we’ll be in touch to tell you about the first stages of the campaign and how you can get started.
Email address *
First Name *
Last Name *
Address (so we can work out your electorate) *
Postcode *
Phone Number (mobile if available) *
Which of the following would you feel comfortable helping us with if we asked you? *
(Please select all that apply)
Required
Have you already been involved in advocating for voluntary assisted dying laws? If so, give us an idea of what steps you’ve taken:
Do you know the name of your local state MP or electorate?
We’ll be setting up a platform for Campaign Champions to work together and support each other. What platforms are you able to use? *
(Please select all that apply)
Required
Building alliances with other community groups will be really important for our campaign. What community groups are you involved in that might be able to support our campaign?
(For example, CWA, Cancer Support groups, Men’s Shed and others)
Any other comments or suggestions?
That's it for now!
Thanks for registering to be a Campaign Champion and completing the survey. The campaign really needs people like you to get involved. The only way our strategy for voluntary assisted dying laws will be successful - is with your help.

We’ll be in touch soon with some actions you can get started with straight away.

Dying with Dignity NSW

By filling out this survey you are giving us permission to contact you on behalf of the Dying with Dignity campaign.
A copy of your responses will be emailed to the address you provided.
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