Northern Territory Greens Donation

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Thank you for supporting the NT Greens.

This form securely accepts Visa or MasterCard, Credit or Debit cards, using eWAY.

If you wish to pay your NT membership fee as well as making a donation please make your donation on this form but pay your membership here.

Other

Contribution Amount *

$25

$50

$75

$100

$250

Other

Total Amount

I want to contribute this amount every month

Personal details

Contact Name and Phone

First Name *

Last Name *

Phone

Other Information - Multipage Donations

Street Address *

Suburb/Town *

Country *

State *

Postcode *

Phone

Your Comments (Optional)

NOTE: If you wish your donation to be used for a specific purpose please indicate that in the Comments field above.

Summary

Payment

Please choose which payment method you prefer. We will then transfer you to our payment partner for processing.

Billing Name and Address

Street Address *

Suburb/Town *

Country *

State/Province *

Postal Code *

The first $1,500 of membership fees
and/or donations to a political party from
individuals in a financial year are tax deductible.

For the purposes of maintaining the integrity and transparency of our fundraising activities, those donating $1,000 or more in a 12 month period will be subject to review according to our donations policy here and added to our donor listing here. There is further information regarding disclosures to the Australian Electoral Commission here.

I am an Australian Citizen or Permanent Resident