Get Involved
New membership

To join the Australian Republican Movement, simply fill out and submit this form.

If your browser does not support forms, if you don't have a credit card, or if you don't want to send your credit card details over the internet, you may print an application form and fax or post it to us instead. If you do not have Adobe Acrobat Reader, download it here.

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Choose Membership Type

 Standard - $48 per year
 Family - $60 per year
 Concession - $12 per year
 Gold - $250 (individual) or $375 (family) per year flat fee
 Benefactor (Life) - A$2000 once-only

Fees include GST. The ARM Membership period runs from 1 June to 31 May. New members joining after 1 March will run into the following membership year.

Personal Details  

Title:

First name:
Surname:

Postal address:

Suburb/Town

State - Australian Residents

 Postcode

Overseas Residents

 State/Province
 Country
 Postcode/Zip

Email address

* If you provide your email address, all future correspondence with you will be conducted by email. We strongly encourage you to do this as it keeps costs down and enables us to disseminate information more quickly.


Date of Birth

*Your DOB is used to verify your identity when you vote in ARM elections.


  Day

 Month

 Year

 I do not wish to disclose my DOB


Telephone:
 Home
 Work
 Mobile

Fax:

  Home
 Work
State electorate:
Federal electorate:
For Concession Membership
Concession category: I am a student
I am unwaged
I am a pensioner or retired
Other
Concession I.D. details:

*Please provide your student ID number and place of study, your Centrelink card number or your Seniors Card number.
 
For Family Memberships

Household Members:

* Please enter the names, dates of birth and email addresses for any household members you wish to include. If you do not provide these details, ONLY YOU will be able to vote in ARM elections. Children. Young Adults between the ages of 16 and 26 on a household membership can only vote in Young Republic elections.
Additional Details - All Applicants To Complete
Have you previously been a financial member of the ARM? Yes No

Do you wish to become actively involved and have your details passed onto your local forum?

Yes  No

If female, do you wish to be a member of the ARM's Women's Network? Yes  No

Payment

The amount to be debited from your credit card is shown for each membership type.



Standard - A$48 per year

Family - A$60 per year

Concession - A$12 per year

Gold - A$250 (individual) / A$375 (family) per year

Life Membership - A$2000 once-only
One-Off Donation Amount A$
Monthly Donation Amount*

* Regular monthly contributions will be charged to your credit card on the first working day of each calendar month 		A$

TOTAL

Membership Fee + One-Off Donation

= A$

Credit Card Type

Name on Card

Credit Card Number (no spaces)

?

Credit Card Expiry Date

I give authority to the ARM to automatically debit my credit card annually when my membership is due for renewal until advised otherwise by me in writing

Yes  No

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Australian Republican Movement 2001