ONLINE FORM

Title

Mr
Mrs
Ms
Dr
Other

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email *

The above details are correct as per the Queensland Electoral Roll. *

Membership Price *

Yearly Fee - $10.00

Please choose your preferred membership options.

Method of Payment

Direct Debit
Cash
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Please choose your preferred method of payment.

Declaration *

I DECLARE that I am over 18 and a registered elector within the State of Queensland.
I DECLARE that I do NOT currently have membership with another Political organisation.

Message

DISCLOSURE WARNING: Commonwealth and State legislation requires disclosure of gifts to registered Political parties. Donations accumulating to $1,000 or more will be disclosed to the ECQ.

Payment

Bank Acct: North Queensland First
BSB: 064-724
Acct No.: 1058-2424

Once you have submitted your form, please forward your cheque or EFT remittance details to:

North Queensland First
PO Box 8274
Mt Pleasant, QLD 4740

or email: secretary@nqfirst.com.au

Printable Form

Download our printable PDF membership form.

DOWNLOAD

North Queensland First believes in all Queenslanders and Australians getting a ‘fair go’, especially those people living in regional, rural and remote communities, and furthermore, we believe in the uniquely Australian concept of “mateship”.

CONTACT

The Secretary
P O Box 8274
Mt Pleasant QLD 4740
Ph: 0412 491 800