The voice of the people TM Registered Trade mark

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I, the above applicant, apply for membership of One Nation [ Victoria ] on the understanding that:

[ 1 ] I commit to being loyal to One Nation.

[ 2 ] I commit to being bound by and to comply with the Constitution of One Nation.

[ 3 ] I commit to working to achieve the Objectives of the Party.

[ 4 ] I am not currently a member of another Political Party.

[ 5 ] I have the following special talents/skills which will assist the Political Party achieve its objectives

[ e.g. Funding, Secretarial, Corporate contacts, Community profile, Election Campaign experience

[ 6 ] I have not been convicted of a disqualifying electoral offence within 10 years before the date of this

application

[ 7 ] I am eligible to enrol for Federal / State Elections. I consent to this form being sent to the A.E.C. /

V.E.C. in support of the Party’s application for registration

Membership will be for 12 months from date of approval by the State Executive following receipt of the application and membership fee. Note: Membership fees are subject to change from time to time in accordance with the Constitution

Please note: All new memberships are subject to a 30 day probationary period. Any application will be scrutinised by the State Director or the State Executive if deemed necessary.

If you can further assist, please include a donation to help One Nation

PO Box 439

OFFICE USE ONLY: Amount received $ Receipt No.----------------Membership No.---------------

Received by--------------------------------Date / / 20 Approved by-----------------------------Date / / 20