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Socialist Civil Liberties Association
either
print off this Form, complete and send as E-mail Attachment OR  mail hard-copy to >

APPLICATION FORM
Individual Membership

My name is (full)..........................................

 ...................................................................

Address ......................................................

 ...................................................................

 ...................................................................

Contacts (tel) (fax) (mobile) (E-mail) 

..................................................................

 ..................................................................

Constituency LP ............................ ............ Party Membership No

 .................................................................

Having considered the SoCLA Constitution,
I hereby APPLY for Membership
I enclose/will send (a) £5 Individual
(b) £ ............. (donation) = Total £.............

Signed ......................................................
Date ................. .......................................
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APPLICATION FORM
for Affiliation

I make this Application on behalf of -

Name...........................................................

Address of Organisation...............................

 ...................................................................

 ..................................................................

Our Representative has been nominated >

Name..........................................................

Address ......................................................

 ...................................................................

 ...................................................................

Contacts (tel) (fax) (mobile) (E-mail) 

 ..................................................................

Constituency LP ............................ ............ Party Membership No

 .................................................................

The above organisation hereby APPLIES for Affiliation  I enclose/will send
(a) £15 Affiliation Fee
(b) £ ............. (donation) = Total £.............

 

Signed ......................................................
Date ................. .......................................

 

 

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