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I am a registered elector enrolled in the above electorate. *

I am NOT a registered elector but I am eligible to enrol. *

Acceptance of this application is on receipt of membership payment. I enclose/have paid my$5.00 for standard membership fee ( for 3 years membership) at the time of this application by Direct payment via internet banking to the New Nation Party - NNParty bank account 01-0181-0610911-00 and have notified New Nation Party of payment by emailing newnationpartynz@gmail.com. *

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I authorise the New Nation Party-NNParty to record my name as a financial member of the New Nation Party-NNParty. *

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I authorise the secretary of New Nation Party-NNParty to release this application form and subsequent financial membership details to the Electoral Commission for the purposes of New Nation Party-NNParty's registration under the Electoral Act 1993. *

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Date of Joining Application *