"*" indicates required fields Personal DetailsAre you an existing member?* Yes No Membership ID:*Please indicate your existing Membership IDName* Mr.Mrs.Ms.Dr Prefix First Middle Last Date of Birth* DD slash MM slash YYYY Phone*Mobile*Email* Residential & Postal AddressResidential Address* Street Address City Australian Capital TerritoryNorthern TerritoryNew South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia State Postcode Postal Address* Same as residental address Street Address City Australian Capital TerritoryNorthern TerritoryNew South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia State Postcode Membership DetailsAre you on the electoral roll?* Yes No My main interest(s) are:* Shooting/Hunting Fishing Farming 4WD/Camping Other Select Membership Type* FULL Membership (1 Year) $30 PENSIONER Membership $20 Do you wish to pay for one year or go onto a recurring membership?* Yes No If “yes”, you will be charged annually. If you need to cancel your membership please get in touch with us.This field is hidden when viewing the formApply Family Discount 10% – only applies if you have other members of the SFFP in your immediate family 10% Family Discount* Price: $ 0.00 Coupon Total Payable Authorisation and PaymentConsent* I acknowledge and agree that whilst I am a member of The SFFP WA Party, I will also be a member of the Federal Shooters and Fishers Party. The West Australian Electoral Commission may contact me to verify my membership.*Signature*Credit CardCard Details Cardholder Name Please be advised, you may be contacted by the West Australian Electoral Commission to verify your enrollment.