Membership Renewal

Membership Number (if known)
Your Details*
Title First Name Middle Name Last Name
Your Date of Birth
Email*
Mobile number*
Occupation
Update Address (If applicable)
Street Address Address Line 2 City State Postcode
Postal Address
- My postal address is different from my residential address
Postal Address
Street Address Address Line 2 City State Postcode
Is this a single or partnership membership?*
- I am the only person on this membership
- My partner is already included on this membership
- I would like to add my partner to this membership for the first time
Partner Details
Partner's Name*
First Last
Partner's Email*
Partner's Mobile*
Add my partner to the membership
Partner's Name*
Title First Middle Last
Partner's Email*
Partner's Mobile Number*
Partner's Date of Birth*
Do they have a preference of Branch allocation?*
- Yes
- No
If not, you will be allocated to your local Branch and District Council.
Branch Preference
I/We confirm that I/we are Australian citizens.*
- Yes
- No
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

Partner Details