RepresentUs Australia

RepresentUs Australia

Sign Up For Independent Representatives

To apply to be an Independent Community Representative candidate for your community please provide your details below:

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Username:
Password:

Email:
First Name:
Middle Name:
Last Name:
Gender:
DOB:
Post Code:

Contact Information And Feedback

As a potential Independent Representative candidate for your community we need the following information:

Phone / Cell:
Address:

Feedback

How did you hear about the RepresentUs Movement?
What made you decide to join the RepresentUs Movement?
Can you please provide your social address? For example, FB, Twitter or Instagram.
If you don't have any social presence can you provide a third party reference to confirm your identity?