Australian Independence Party

PO Box 2759, Seaford, Vic 3198
Phone 03 9773 6064
WEB site
Phone   (b)  
Fax   (b)  

Annual Membership fees
Full Member -  $30.00
Associate (no voting rights) -  $20.00
Student or Pensioner (no voting rights)       -  $10.00

All donations are of course most welcome as well as any support or help that anyone can provide.

Please find enclosed my donation of  $ _______________

I wish to become a member of the above party.
I am eligible to enrol for Federal Elections.

(You are eligible to enrol for Federal Elections if:

  • you are 17 years of age or older; and
  • you are an Australian citizen; and
  • you have lived at your present address for at least the last month)

British subjects who are not Australian citizens are eligible to enrol for Federal elections is they were on a Commonwealth of Australia electoral roll on 25 January 1984.

I consent to this form being forwarded to the Australian Electoral Commission in support of the party's application for registration. (Strike out if not applicable)

I declare that the information I have given on this form is true and complete.



  What skills/talents do you have?
  • Secretarial (ie: typing, filing, answering phones)
  • Computing (ie: wordprocessing, database, e-mail)
  • Desktop Publishing (ie: newsletters, brochures)
  • Fundraising
  • Public Relations
  • Media/Corporate Contacts
  • Accounting/Audit
  • Research
  • Speechwriting
  • Management/Leadership
  • Other:

Are you able to assist in an election campaign? If so, how?

  • Campaign Management
  • Letter box drops
  • Door knocking
  • Manning polling booths
  • Scrutineer
  • Other:

Are you able to assist your local AIP branch? If so, how?

  • Committee Member (ie: President, Secretary, etc)
  • Fundraising
  • Newsletter circulation
  • Other:

Do you have any experience/interest in any of the following issues? If so, please tick which ones.

(We may wish to seek your assistance to review proposed Parliamentary legislation / policy development)

  • Aboriginal & Torres Strait Islander Affairs
  • Arts
  • Regional Development
  • Attorney-General
  • Communication & Information
  • Disability Services
  • Education
  • Emergency Services
  • Employment, Training & Industrial Relations
  • Environment & Heritage
  • Fair Trading
  • Families, Youth & Community Care
  • Health
  • Housing
  • Justice
  • Local Govt & Planning, Regional & Rural Communities
  • Transport & Main Roads
  • Mines & Energy
  • Natural Resources
  • Police & Corrective Services
  • Primary Industries
  • State Development & Public Works
  • Tourism, Sport & Racing
  • Trade