Membership Application Form | United Democratic Alliance

UDA MEMBERSHIP APPLICATION FORM

For Such A Time As This...

Province *

Passport-Size Photograph

JPG or PNG, maximum 5MB

A PERSONAL DETAILS

Surname *

First Names *

Sex *
MaleFemaleOther

Date of Birth *

National ID / Passport Number *

Nationality *

Marital Status

Residential Address *

B CONTACT DETAILS

Primary Mobile Number *

Email / WhatsApp *

C ELECTORAL AND PARTY PLACEMENT

Province *

Constituency *

Ward Number & Name *

Polling Station *

Wing *
MainWomenYouth

Registered Voter *
YesNo

Voter Roll Address (if different)

D NEXT OF KIN / EMERGENCY CONTACT

Full Name *

Relationship *

Mobile Number *

Residential Address *

E DECLARATION BY APPLICANT

I HEREBY DECLARE THAT:

The information supplied in this application is true and correct, and I agree to abide by the Constitution, rules and regulations of the United Democratic Alliance from time to time.
I understand that this application may be declined and that the organisation reserves the right to decline this application or revoke my membership.
I am not, or am no longer, a member of any other political party or entity and shall not join another political party while I remain a UDA member.
I agree to abide by the Constitution, policies, rules, regulations and Code of Conduct of the United Democratic Alliance.
I am enrolled, or shall enrol, on the voters' roll with the Zimbabwe Electoral Commission at the residential or voter-roll address supplied above.
I understand that it is an offence to make a false declaration.

I confirm that I have read and accept the above declaration and voluntarily apply for membership of the United Democratic Alliance (UDA).

* Required fields