Please Help Us To Help You

Libby.WMF (8032 bytes)

 

 
Unlike the other big parties - who rely on big business and trade unions - the Liberal Democrats rely on our members and supporters for funding. All our campaigning is paid for by our individual supporters - please do your bit to help our success even more.
 
We would be grateful if you would complete the form to register yourself as a member or supporter of the Liberal Democrats.
 
For which purpose are you completing this form? (select one):
 
MEMBERSHIP APPLICATION
MEMBERSHIP RENEWAL
SUPPORTER'S DONATION
Your name

E-Mail

Address
House/Street
Town
County
Post Code
Telephone Number

The recommended subscription for members of the Party is £28.00.

The minimum is £4.00..

How much would you like to contribute?

One year's membership (or donation)
£35.00
£28.00 (Recommended)
£20.00
£5.00
£4.00 (Students only)
Other - please specify

Method (Choose one)

Call me for my credit card details
Please send me a direct debit form
Please send further details to the address above

You do not have to fill in the remaining sections, but it will help us if you do.

  Occupation (or former occupation)
 
Anything you feel might be of interest
 
You may be interested in helping in practical ways such as:
donating money occasionally
delivering some Focus leaflets occasionally
helping out on election day
entering computer data
helping with fundraising or social events
clerical work
conducting surveys
recruiting new members
canvassing voters
other

 

Thank you for completing this form. Someone will get back to you in the next couple of days.

Please now your application or it           

 

 

Published and promoted by Shaun Haynes on behalf of the Liberal Democrats, both at 1 Green Street, Middleton. M24 2HT

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