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New Membership, Membership Renewal and Donations by Cheque
to The UK Independence Party Greenwich Branch
Cut and paste the following into your word processing package:-
Title.................. Forename(s)................................................
Surname...............................................................................
Address...............................................................................
Town...................................................................................
County.............................................. Postcode...................
Telephone (Day) ............................. (Evenings) ....................................
Parliamentary constituency if known......................................
Please indicate here whether you would be interested in:
[ ] becoming an active member of a local branch;
[ ] standing as a candidate;
[ ] assisting in campaigns/leafleting
Donation To UKIP :
Total Enclosed : £ ...............................................................................
Membership Subscription :
One year's membership: £ 20.00 [ ]
Pensioner, Student, On Benefits £ 10.00 [ ]
Total enclosed: £...............................................................................
Membership Renewal :
One year's membership: £ 20.00 [ ]
Pensioner, Student, On Benefits £ 10.00 [ ]
Membership Number : .........................................................................
Make cheques payable to UKIP SE London and post to :
The Chairman, Greenwich UKIP, 43 Highfield Road Dartford Kent DA1 2JS
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