Join - The Nationals Victoria

Step 1: Select your membership type*
- Standard Membership - $100 per year
- Young Nationals (up to 35 years old) - $10 first year only*
- Young Nationals (up to 35 years old) - $50 per year
- Pensioner/Retiree Membership - $50 per year
- Gold Membership - $500 per year
- Platinum Membership - $1000 per year
* non voting
Total
$ 0.00
Auto renew
Renew my membership each year
To cancel your auto renewal, please email vic@nationals.org.au

Your Details*
Title First Name Middle Name Last Name
Your Date of Birth
Email*
Mobile Number*
Residential Address (as per electoral roll)*
Street Address Address Line 2 City State Postcode
Occupation*
Postal Address
- My postal address is different from my residential address
Enter your full postal address
Partner
- I would like to add my partner to this membership.
Partner's Details
Title First Name Middle Name Last Name
Partner's Date of Birth
Do you have a preference of Branch allocation?*
- No
- Yes
Branch Preference
Do you know any current Victorian National Party Members?*
- Yes
- No
Please name them here
I/We confirm that I/we am not a member of any other political party (as per Rule 5 of the Party's Constitution).*
- Yes
- No

Credit Card*
Card Number
Cardholder Name
Consent*
I confirm that the above statements are true and accurate, I am not a member of any other political party and I am over the age of 15*
Comments
This field is for validation purposes and should be left unchanged.