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What this form is for
A member of a political party can complete this form and send it to their party so it may be used to help establish or confirm the party’seligibility for registration in NSW.
How to use this form
• Only the party member may complete this form. It must not be altered or pre-filled.• This form is sent to the party (not to the NSW Electoral Commission) when completed.• The party member can check their details on the electoral roll to ensure accurate information is provided.
Privacy
The NSW Electoral Commission is committed to protecting the privacy of the personal information it collects, manages and stores.The information collected on this form will be used by the NSW Electoral Commission to confirm a party’s eligibility to be registeredfor NSW State and/or local government elections. This form may also be used by the NSW Electoral Commission to undertake itsstatutory and administrative functions relating to the registration of a political party. Not supplying all the information requested maydelay or prevent the NSW Electoral Commission confirming a party’s eligibility to be registered. The form is held by the NSW ElectoralCommission and accessible by relevant staff and its contractors. If required or authorised by law, information on this form may bemade available for public inspection. It may also be disclosed to other persons or entities if required or authorised by law. We may alsouse your contact details to invite you to confirm your membership of a party. You can find additional information in the NSW ElectoralCommission’s Privacy Management Plan concerning access to and correction of your personal information.Please note that this form may be viewed as part of a public inspection of a registered political party’s information. If a silentelector provides their address it will be redacted before the form is made available for inspection.
Christians for Community
THE NAME OF THE PARTY OF WHICH I AM A MEMBER
I consent to the above party relying on my membership for the purpose of qualifying for eligibility for registration under the Electoral Act 2017 and/or the Local Government Act 1993 (as applicable). The Electoral Commissioner for NSW may, in order to verify the requirements for this party’s eligibility for registration, contact me to confirm that I am a member of the party.