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Joining Is Simple Yes, I want to join the Australian Greens Joining is simple ACT Greens ACT GPO Box 2019 Canberra ACT 2601 Determine the relevant membership fee and return the completed form to the address listed for your state or territory shown on the left of this page. T: (02) 6140 3220 • www.act.greens.org.au $20 concession $30 income up to $30,000 $60 income $30,000-$45,000 your details $90 income $45,000-$60,000 Title First Name Last Name $120 income over $60,000 The Greens NSW Residential Address NSW GPO Box 1220 Sydney NSW 2001 T: (02) 9045 6999 • www.nsw.greens.org.au Suburb State Postcode 12-month rate if renewing or joining between Jan-Jun $20 concession $60 low income $120 salaried $5 under 25 Postal address (if different to above) The Greens NT Suburb State Postcode PO Box 421 Nightcliff NT 0814 NT T: 0416 267 366 • www.nt.greens.org.au $5 unwaged $30 income up to $35,000 Email Mobile phone $60 income $35,000-$55,000 $90 income $55,000-$75,000 Work phone Home phone $120 income over $75,000 Queensland Greens Occupation Gender Date of birth / / PO Box 661 Albion BC 4010 QLD T: (07) 3173 1127 • www.qld.greens.org.au $120 individual membership (annually) declaration $60 Low income individual(annually) I am not a member of another political party and will not join another political party while I am a member of The Greens. I agree to abide by the Charter and Constitution $30 Concession individual(annually) of the Australian Greens, and the Constitution of my state/territory party. I acknowledge that my membership is subject to approval by The Greens party in the state/ $15 Family Greenscheme (monthly) territory where I reside. $10 Individual Greenscheme (monthly) / / Australian Greens SA Signature Date 239 Wright Street Adelaide SA 5000 SA T: (08) 8212 4888 • www.sa.greens.org.au $10 Greenscheme (monthly) $30 concession $60 standard membership fee Tasmanian Greens payment TAS GPO Box 1132 Hobart TAS 7001 Membership fee $ Donation $ T: (03) 6236 9334 • www.tas.greens.org.au $10 Grenscheme (monthly) $20 concession $30 income up to $30,000 Total payment $ Regular monthly donation $ $60 income $30,000-$45,000 $90 income $45,000-$60,000 I would like my membership renewed automatically and authorise The Greens in my state/territory to debit my credit card for the $120 income over $60,000 amount of membership fee indicated above, or future membership fees as determined by my state/territory party. VIC Australian Greens Victoria GPO Box 4589 Melbourne VIC 3001 Visa Mastercard Cheque or money order enclosed (please make cheques out to your state Greens party) T: (03) 9602 1141 • www.vic.greens.org.au $30 concession $60 income up to $30,000 Card number Expiry date $90 income $30,000-$45,000 / $135 income over $45,000 Name on card WA The Greens (WA) CCV PO Box Y3022 Perth WA 6832 T: (08) 9221 8333 • www.wa.greens.org.au Signature Date $20 concession $50 standard/associate / / $1000 lifetime australian greensthe australian greens THE AUSTRALIAN GREENS The Australian THEGreens isAUSTRALIAN a confederation of eight GREENS state and territoryThe Australianparties. Greens is a confederation of eight state AUSTRALIAN Theand territoryAustralian parties. Greens is a confederation of eight state AUSTRALIAN and territory parties. The Greens areTheand founded territoryGreens onareparties. thefounded principle on the ofprinciple of grassroots GREENS grassroots democracy,Thedemocracy, Greens which whichare founded means means on that the every everyprinciple member of grassroots can have GREENS member can havedemocracy,input input into key intowhich decisions. key means decisions. that every member can have input into key decisions. By joining your Bystate joining or territoryyour state party, or territory you party,become you become a Bymember joining of your the Australianstate or territory Greens party, – helping you become to achieve a a a member of thememberfair, Australian sustainable of the AustralianGreens and independent - Greenshelping Australia.– tohelping to achieve a achieve a fair, sustainablefair, sustainable and and independent independent Australia. The Greens are the growing third force in Australian politics.The Greens We arepromote the growing a progressive third force agenda in Australian based on The Greens arepolitics. the growing We promote third a force progressive in Australian agenda based on politics. We promotefourpolitics. principles: a We progressive promote a progressiveagenda based agenda based on four principles: on four principles: Ecological Sustainability ecologicalEcological sustainability Sustainability social justiceSocial Justice peace &Peace non-violence & Non-Violence grassrootsGrassroots democracy Democracy join Grassroots Democracy join join www.greens.org.au Authorised by Derek Schild Ground Floor Unit 4, 8-10 Hobart Place, Canberra Australian Greens membership form AUSTRALIAN GREENS Authorised by Alison Xamon Ground Floor Unit 4, 8-10 Hobart Place, Canberra AUSTRALIAN GREENS AuthorisedPrinted on by 100% Alison recycled Xamon paperGround by Floor Wombat Unit Grafx 4, 8-10 6 StokesHobart AvePlace, Alexandria. Canberra MEMBERSHIP FORM AuthorisedPrinted on by 100% Alison recycled Xamon paperGround by Floor Wombat Unit Grafx 4, 8-10 6 StokesHobart AvePlace, Alexandria. Canberra MEMBERSHIP FORM Printed on 100% recycled paper by Wombat Grafx 6 Stokes Ave Alexandria. MEMBERSHIP FORM.
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