Given Name * Middle Name Family Name * Date of Birth * Residential Address * Must not be a PO BOX. Suburb * State/Territory * Please Select ACTNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Postcode * My postal address is different to my residential address * Yes No Postal Address * Postal Suburb * Postal State/Territory * Please Select ACTNew South WalesNorthern TerritoryQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Postal Postcode * Email * Phone Number (Mobile) * Phone Number (Home) Phone Number (Work) How did you hear about the party? Print MediaTelevisionRadioWeb SearchFacebookTwitterIron First Velvet Glove PodcastFrom a FriendOther How did you hear about the party? Filling this out will help us better target our advertising to help gain new members and build a stronger party. Email Correspondance Monthly Newsletter Campaigns Members Email Group As a party member you can stay in informed with the latest news and events by subscribing to our various email lists. Are a member of another Political Party within Australia * No Yes The AEC allows for you to be a member of multiple parties. We need to know if you are a member of an alternate party as we are not permitted to use your membership towards our minimum requirement total. Membership of other Party Australian Labor PartyLiberal National PartyThe GreensOther Membership of other Party Declaration I wish to become a member of the above political party. I support the Aims of the Secular Party of Australia as detailed in the Party's constitution. I am eligible for Federal elections. i.e. I am 17 years of age or older; I am an Australian citizen (or a British citizen who was on the Australian electoral roll on 25 January 1984) and I have lived at the above address for at least one month. I consent that the information provided in this form may be forwarded to the Australian Electoral Commission (AEC) in support of the Party's continued registration as a political party and I agree to confirm my Party membership to the AEC if queried by them. I declare that the information I have given in this form is true and complete. I acknowledge that yearly membership fees apply outlined in the Membership page. Privacy This form may be forwarded to the AEC to confirm that the Party continues to meet the registration requirements. The AEC may contact you to confirm that you are a Party member and that you have submitted this form. The AEC may enter the details on this form into a database for cross-checking purposes. The information will be treated as confidential by the AEC. Acceptance * I have read, understood and agree to the above declaration.