Please answer every question. Please provide your residential address according to the records of the Australian Electoral Commission. The second line of the address is optional. Your Family Name: Your Christian Names: Your Title: Your Date of Birth: Residential Address: Suburb or Town: Postcode: State: Choose one New South Wales Victoria Queensland South Australia Western Australia Tasmania Northern Territory Australian Capital Territory Norfolk Island Christmas Island Cocos (Keeling) Islands Coral Sea Islands Australian Antarctic Territory - Country: Postal Address: Suburb or Town: Postcode: State: Choose one New South Wales Victoria Queensland South Australia Western Australia Tasmania Northern Territory Australian Capital Territory Norfolk Island Christmas Island Cocos (Keeling) Islands Coral Sea Islands Australian Antarctic Territory - Country: Home Telephone: Mobile Telephone: E-mail Address: Do you support the White Australia Policy of not allowing Asians and Africans to live in Australia? Yes, I SUPPORT the White Australia Policy No, I DO NOT SUPPORT the White Australia Policy Have you attended a Catholic primary or secondary school? Yes, I HAVE ATTENDED a Catholic school No, I HAVE NOT ATTENDED a Catholic school Are you an Australian citizen? Yes, I AM an Australian citizen No, I AM NOT an Australian citizen By sending this application, you are agreeing to be bound by the constitution of the Mainstream Party. The Party may enrol you from time to time as a member of the State and Territory branches of the Party, and as a member of the Party's youth wing. Currently there is no membership fee. You agree that, if you are contacted by the Australian Electoral Commission, or other government agencies, and they ask you whether you are a member of the Mainstream Party (or a branch of the Party, or the Party's youth wing), you will tell them that you are a member. Please make sure that you have answered all the questions, otherwise the computer will not be able to process your application.
