Application for Membership of Pauline Hanson's One Nation Political Party Please Print - Block Letters Title First Name Title First Name Surname Street Town/Suburb Postcode Post Address Ph(H) Town/Suburb Ph(W) Postcode Mobil e Fax E-mail I/We, the above-mentioned applicant(s), submit my/our  name(s) for membership of Pauline Hanson's One Nation Political Party on  the understanding that: 1. I/We commit to being loyal to the Political Party. 2. I/We commit to being bound by and to comply with the State  Constitution of the Political Party. 3. I/We commit to working to achieve the objectives of the Political  party. 4. I/We am/are not a member of another Political Party or any  organization with views unacceptable to ordinary, decent  Australians. 5. I/We have the following talents/skills which will assist the  Political Party to achieve its objectives.(eg. Fundraising, secretarial,  corporate contacts,  community  profile, election campaign experience,  other) (Couples to both sign)………………………………………………………………………………………………………… Applicant's Signature: ………………………………………  …………………………………………… Date: ……/…../…….. Witness: ……………………………………………. Membership will be for 12 months from the date of approval  by the State Executive following receipt of the application form and  membership fees. Note: membership  fees  are subject to change from time to  time in accordance with the relevant constitution. A copy of the State Constitution will be available to financial members  on request to the Branch or State Executive. MEMBERSHIPFEES:   Single ................................ $44.00                              Couple ........................... $55.00   Pensioner Single .............. $22.00                               Pensioner ...................... $27.50 All fees include the G.S.T If you can further assist, please include a donation to help Pauline  Hanson's One Nation election campaigns against well funded  opponents. My special donation to support Pauline Hanson's One Nation Political  Party is $…………….. Please return to: OFFICE USE ONLY: Membership  No……………… PAULINE HANSON'S ONE NATION BROKEN HILL BRANCH Amount Received $ Receipt No………………………. P.O. BOX 155 BROKEN HILL NSW. 2880 Received by:………………………….Date: / /20 Approved by:…………………….……Date / /20 Renewal date:………….. Branch …………………. If you want to become a member of Pauline Hanson's One Nation all you have to do is press print and include a cheque or money order made out to Plauline Hansons One Nation Broken Hill Branch and post it to the address on the form [Back To The Home Page]