One New Zealand Party | Join Us

Name *

First

Last

Street Number & Street Name *

Suburb

Town/City *

Postcode *

Best Contact Number (Mobile) *

Email *

Please enter your email, so we can follow up with you.

Electorate (if known)

I am a registered elector enrolled in the above electorate.

Yes
No

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

Yes
No

I am eligible to enrol as a New Zealand parliamentary elector as I am a (select one): *

New Zealand citizen
permanent resident of New Zealand
other - please specify below

If you live overseas, provide the date last in NZ:

How would you like to be involved with the One New Zealand Party? *

Please advise details if you ticked Other above

What is the best way to contact you? *

Email
Phone
Other

If you ticked Other above, please advise how we should contact you

Would you like to become a financial member of the One New Zealand Party? *

Yes
No
Not sure yet

I enclose/have paid my membership fee of $5.00 for a 3 year membership with this application. All fees to be paid directly to the One New Zealand Party bank account 38-9020-0358617-00 and emailed to onenewzealandparty@gmail.com before this application is accepted.

Yes
No

I authorise the One New Zealand Party to record my name as a financial member of the One New Zealand Party.

Yes
No

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

Yes I agree to this
No I do not agree to this

Date of Joining Application

Any other relevant information