Socialist Alliance Western Australia
Please support our right to stand Socialist Alliance candidates in the March 2017 state election by filling out this form. There is no financial or other obligation of membership, but you must be on the electoral role in Western Australia and may be contacted by the WA Electoral Commission to confirm your details. If they leave a message please respond.

If you would like to get active and become a financial member of Socialist Alliance National then please check the box at the bottom of this form.
Our lives are worth more than their profits
For the billions not the billionaires!
Surname (as on the electoral roll in WA) *
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Given Names *
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Date of Birth *
Email address
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Daytime phone *
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Alternative phone
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Residential address *
Please enter the address where you are registered with the Electoral Commission
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I confirm that I am a member of Socialist Alliance WA, I consent to this form being forwarded to the WA Electoral Commission in support of the party's application and I declare that all the information I have given on this form to be true and complete. *
I would like to be contacted about events
I would like to get active with Socialist Alliance
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