Application for membership to the Association Application for membership to the Association Note: This form may contain additional information as required by the Electoral Commission. Surname * Given Names * Address * Address Address Address City City State State Postal code Postal code Home Phone Work Phone Mobile Phone Email Address * Declaration * I desire to become a member of The Secular Party of Australia Inc. In the event of my admission as a member, I agree to be bound by the rules of the Association for the time being in force. I agree that this membership may apply for a fixed term (if applicable) as determined by the Committee. Submit If you are human, leave this field blank.