UKIP Cornwall

UK Independence Party - Cornwall





UKIP Membership Form


Please fill-in this form on screen using your mouse and keyboard.
Print two copies, then sign and date them. You will find a "print" button at the bottom of the form. 
Keep one copy and post one to:

Membership Secretary, Greenwood Cottage, Polmoria, Wadebridge, Cornwall, PL27 7JU.

Enclose a cheque made payable to North Cornwall UKIP.

Required items *

IMPORTANT: Membership is subject to the terms and conditions given at the end of this form. Click Terms & Conditions









Please tick the box for an information pack

Please tick the boxes below if you are able to help us

Distribute leaflets
Be a candidate in a local election
Man telephones during the day in an election
Canvass

Please select your class of membership

I agree to abide by the UKIP constitution and the terms and conditions of membership and I give permission to UKIP to store my details in its databases in accordance with the Data Protection Act. UKIP never discloses member's details to other persons or organisations other than UKIP.



Signed____________________________ Date_________________




Membership is subject to the terms and conditions as follows:

By applying for membership of UKIP, I agree: To abide by the UKIP Constitution and the Terms and Conditions of Membership (available here). I am not and have never been a member of the British National Party, National Front, British Freedom Party, British People's Party, English Defence League, Britain First or the UK First Party. UKIP reserves the right to reject applications or terminate memberships if these criteria are not met.

 

Copyright 1993-2014 © UK Independence Party. Promoted by the United Kingdom Independence Party, Lexdrum House, Unit 1, King Charles Business Park, Heathfield,
Newton Abbot, Devon, TQ12 6UT (Form downloaded from www.ukipdevon.org.uk)

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