Anti-Nuclear Party Enrolment

Anti-Nuclear Party Enrolment

Fighting for a renewable future not a radioactive one
Help us get 1500 members by filling out the following form with your details as they appear on the electoral role.

Thank you for joining the stand against nuclear in Australia!

Please note: You can only be enroled in one political party at a time.
Full Name*

PrefixFirst NameLast Name
Date of Birth

DayMonthYear
Phone Number*
E-mail*
Address*

Street Address

Street Address Line 2

City / SuburbState / Territory

Post Code
Join the mailing list for Party updates?

Yes please!No thanks!
By submitting this form you consent to have the information provided shared privately and exclusively with the Australian Electoral Commission (AEC). Upon Party registration, the AEC may contact you to verify your membership.
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(We won't share this with the AEC)
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