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"Accountable Representation for the
People" Now that you have read about the reform party why don't you join and assist us in breaking the domination of the major parties. Just print this page and complete it and return it by mail. Forward
to Secretary
Australia Reform Party PO
Box 310 Epsom
Vic 3551 REQUEST FOR MEMBERSHIP / MEMBERSHIP RENEWAL
PLEASE RETURN THIS FORM WITH YOUR PAYMENT Name: ________________________________________ Address
_______________________________________ Town/city __________________ Postcode ___________ Phone
Daytime________________AH____________________
Email Address
_______________________@________________________
If
renewing; MEMBERSHIP
NUMBER: ____________ CURRENT
RENEWAL DATE: __________ ____ FULL MEMBER $20.00 _____PENSIONER / STUDENT $10.00 We would
appreciate any further monies that you wish to enclose as a donation. PLEASE FIND ENCLOSED PAYMENT FOR THE AMOUNT
OF: $
.00
Did you know: you can find us on the World Wide Web at www.reform.org.au
Authorised by: Ian Dean Goynes Rd Epsom.. |
