AEC
Australian Electoral Commission
Appendix 1                 Federal Registration of Party Members                                   

            APPLICATION FOR MEMBERSHIP

          THE FISHING PARTY 

Surname

 

 

Please Print

Given Names

Show given names in full

Residential Address

 

 

  City/Suburb

 

 

  State

 

  Postcode

 

 Telephone (W)

 

(  )

 

  Telephone (H)

 

 

  Fax

 

  (  )

 

  Date of Birth

…../…../…..

 

Declaration  
 I wish to become a member of the above party  
I am eligible to enroll for Federal Elections
(You are eligible to for the Federal election if;)

 ·          You are 17 years old or older; and  
·         
You are an Australian citizen; and  
·         
You have lived at your present address for at least the last month  
 (British subjects who are not Australian citizens are eligible to enroll for Federal elections if they were on a Commonwealth of Australia electoral roll on 25 January 1984.)  
 
·          I consent to this form being forwarded to the Australian Electoral Commission in Support of the party’s application for registration (Strike out if not applicable)  
 I declare that all information I have given on this form is true and complete

 

Signature                                                                                                      Date …….…/…....…/…..…..

 Note:                 Declaration of membership must be completed by (or at the direction of) the party member concerned and then signed by the member. Particulars are to be written by hand at the same time as the form is signed.
Each declaration of membership is to be made on a separate sheet of paper
.
 The Electoral Commission may, in order to verify the requirements for registration of the party, request a person who signs a declaration of membership to confirm that the person completed and signed the form  
 
We do not disclose any personal information that we hold on any members to any third party, except where the member has given express consent for us to do so or  we are required by law to do so

 PLEASE ATTACH CHEQUE FOR $22(3 YEAR MEMBERSHIP) AND FORWARD TO “THE SECRETARY . THE FISHING PARTY (Qld) PO BOX 1311.  AIRLIE BEACH Qld 4802”