Community Preselections Participation

Name(required)

Address(required)

Telephone(required)

Email(required)

Federal Electorate(required)

I would like to participate as a:(required)

Are you a current or recent member of the Liberal, National, Labor or Green parties? If you are a member of any other political party, please tell us.(required)

Date of Birth (We are not interested in your age, this is solely for the purpose of electoral roll validation for Electoral Commissions)(required)

Tell us about yourself and your political interests(required)

Payment - EFT to CBA, BSB 062 218, Account 1007 2945(required)

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