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Authorised by J.D. Hodges, 77 Flaxton Mill Road, Flaxton. 4560 for the Motorists Party.

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Join The Motorists Party

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First Name*

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Surname*

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(street) Number*

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Street Name*

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Suburb*

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Postcode*

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E-mail*

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Mobile*

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Date of Birth DD/MM/YYYY*

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DOB is a requirement made by the electoral commission. All personal information is kept confidential and only shared with electoral officials for party registration purposes.

How did you hear about us?*

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Yes, I’d like to help by

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(tick box) Member Agreement*

“I support Motorists Party policies. I understand that I can change or cancel my membership at any time by sending written notice to the Secretary.” Invalid Input

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