Elections ACT

Application to register a political party for
ACT Legislative Assembly elections	
Please read the “How to register a political party” handbook to assist you to complete this form.
A copy of the party’s constitution and a list of at least 100 members must accompany this application.	
	
Enquiries and this form should be addressed to:	
	
Elections ACT, PO Box 272, Civic Square ACT 2608		
                         O’Connell Centre, Cnr Stuart Street & Blaxland Crescent, Griffith ACT 2603			
Telephone: 6205 0224	Fax: 6205 0382	Email: elections@act.gov.au	Website: www.elections.act.gov.au	
	
Details of proposed party	
			
Proposed name of party:			
			
Proposed abbreviation of name
(if any):			
			
Address for party correspondence:			
	Postcode:                    		
			
Details of proposed registered officer	
			
Name of proposed registered officer:			
			
Address of proposed registered officer:			
Address can be residential or business, or the party address (but none can be a PO Box).	Postcode:                    		
			
Contact telephone:			
			
Signature of proposed
registered officer:	/          /          		
			
Details of secretary of party	
			
Full name:			
			
Formal title of position held in party:			
			
Contact telephone:			
			
Signature of secretary:	/          /