Friend of HAP

Thank you for offering to become a “Friend” of the Health Australia Party.

Please answer a few questions to enable us to keep you updated with information about the party.

If you have any queries regarding this form please contact us by clicking here.

Price:

Free

First Name:* First Name Required

Last Name:* Last Name Required

I would be interested in volunteering my time to the Health Australia Party

Are you a health practitioner?

My association memberships: My association memberships is not valid

Phone number:* Phone number is Required

Date of birth:* Date of birth is Required

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

 

No val Please fix the errors above