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Country Liberal Party

The Territory Party

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- Senator Jacinta Nampijinpa Price
- Members of the NT Parliament
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Volunteer

Our Team
- Senator Jacinta Nampijinpa Price
- Members of the NT Parliament
Our Party
- About
- Our Plan
- Policies
News
Contact
Volunteer

Get involved! Join the CLP today!

Please choose your membership level

Membership levels available(Required)

Basic Single - $125 per year

Joint - $210 per year

Seniors - $110 per year (proof of Seniors card required)

Concession - $50 per year (proof of Australian Commonwealth Pension Concession card required)

Youth (under 30) - $50 per year

Student (full time) - $50 per year (proof of full time enrolment from Australian registered Education provider required)

Life Membership

Life Membership Option

Please send proof within 30 days to secretariat@countryliberals.org.au

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Admin Date

DD slash MM slash YYYY

Personal details

Name(Required)

Title First Name Surname

Email(Required)

Mobile Phone(Required)

Phone

Address(Required)

Street Address City State Postcode

Postal Address(Required)

As above

Different from above

Postal Address

Street Address City/Town State Postcode

Date of birth(Required)

Branch(Required)

Member 2 details

Member 2 Name(Required)

Title First Name Surname

Member 2 Email(Required)

Member 2 Mobile Phone(Required)

Member 2 Date of birth(Required)

CLP Endorsement

If you do not have endorsement, you will be required to meet with the Branch Chair and attend a meeting prior to your membership ratification.

CLP Member 1

CLP Member 2

Declarations

Have you been a member of another Political Party?(Required)

Yes

No

Please provide details:(Required)

I have never stood against, or assisted someone who stood against, a CLP endorsed Candidate in a Federal, Territory or Local Government election.(Required)

Agree

Disagree

Please provide details(Required)

Declarations(Required)

I declare that I am enrolled on the Commonwealth electoral roll at my address as shown above.(Required)

Declarations(Required)

I declare all the information I have provided is correct and I will abide by the terms of the party constitution.(Required)

Name(Required)

Date(Required)

DD slash MM slash YYYY

Member 2 Declarations

Member 2 - Have you been a member of another Political Party?(Required)

Yes

No

Member 2 - Please provide details:(Required)

Member 2 - I have never stood against, or assisted someone who stood against, a CLP endorsed Candidate in a Federal, Territory or Local Government election.(Required)

Agree

Disagree

Member 2 - Please provide details(Required)

Declarations(Required)

Member 2: I declare that I am enrolled on the Commonwealth electoral roll at my address as shown above.(Required)

Declarations(Required)

Member 2: I declare all the information I have provided is correct and I will abide by the terms of the party constitution.(Required)

Member 2 Name(Required)

Member 2 Date(Required)

DD slash MM slash YYYY

Payment

Total payable today (membership fees, other than life memberships, are calculated from 1 July 2023)(Required)

Price: $ 0.00

Credit Card(Required)

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Authorised by Alyson Hannam for the Country Liberal Party, 2/229 McMillans Road, Jingili NT 0810.