National Electoral Representatives Alignment (NERA)
Please complete the form below if you would like to work in your electorate and become a NERA representative.
Name
*
First Name
Last Name
Email
*
example@example.com
Postcode
*
Phone Number
*
Please enter a valid phone number.
Which federal electorate do you reside in?
Would you like to become an ELECTORAL REPRESENTATIVE in your electorate?
Please Select
Yes
No
I would like more information please
Would you like to become a COMMUNITY COORDINATOR in your electorate?
Please Select
Yes
No
I would like more information please
Would you like to volunteer to assist the ALIGNED COUNCIL OF AUSTRALIA team?
Please Select
Yes
No
Submit
Should be Empty: