Party Membership Application Form
Please fill out the Form below
It is crucial that the information you enter is exactly the same as that which is recorded on the Australian Electoral Role
Please check your enrollment information
here
Find your electorate
here
Given name/s
(enter you given name/s exactly as they are listed on the electoral role - please check your details on the link above)
Family name (As listed on the electoral role - please check your details on the link above)
Email
Confirm Email address
Mobile phone
Federal Electorate (If unsure please use the link above to find your electorate)
Address Line 1
Street address
Suburb/City
Postcode
9999
Postal Address (leave blank if same as residential address)
PO BOX or street address; suburb/city; postcode
I confirm that I am not a member of another registered political party
Submit
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