AAIC Celebrity Ambassador Form Please complete and submit the form below to register as an AAIC Celebrity Ambassador. We will then email you an Information Memorandum once we receive your application. Please complete a short video, around one minute or less stating: Who you are and a brief description of your background. Your views on the impact of the Ice epidemic. A firm statement to our youth - "Don't touch Ice - NOT EVEN ONCE" A statement encouraging all Australians to join you in the AAIC Army to help us Put the Freeze on Ice. Once you complete and send this form you will receive a confirmation email with the video upload instructions. Contact Name Contact Phone Email Address State or Territory Queensland North Queensland New South Wales Victoria South Australia Australian Capital Territory Tasmania Western Australia NorthernTerritory National Post Code Brief description of your background Are you available to speak to the media as an AAIC Ambassador to help promote the AAIC Army and our “Not Even Once” campaign? Yes No Are you available to attend and participate at an AAIC school, club or community event over the next 12 months? Yes No Geographical region where you can attend such an event How many times per year are you available to attend such an event? Do you give your authority for AAIC to post your video on the Internet? Yes No How did you hear about AAIC? submit Please turn on javascript to submit your data. Thank you!
