The Pensioners Party Joining Form

The Pensioners Party

Joining form

Item nos 1 to 8 are essential for the form to work

Information in this box is not mandatory for Associate Membership but helpful.

Free associate membership [Fill in 8 boxes]
First name
Last name
email
email
Region
County

Full membership (please fill in both forms) Only information you are content to divulge.
House No / Name
Street address
Town/Area
Postal code
Home Phone
Mob no
Date of birth
Occupation	or previous experience
Business Phone
Passport photo for potential candidates - please restrict your image size to 50kb. Click on 'Browse' and locate your image on your computer. [jpg-jpeg-gif-png-bmp] If you have problems please email.
Image
Comments	Please provide any comments you might have.

Please select the applicable button below.
Associate Membership [Free]
Full Membership [£10.00]
Full Membership Plus [£10.00]
Life Member [£50.00]

Tick box to ACCEPT the terms, conditions & privacy policy

Prior to SUBMIT button would you like to fill in the right hand box?

Please !!!CHECK!!! have you filled in the 8 items of information.

Having completed the form, read the terms,
conditions, the privacy policy, please push the SUBMIT button ONCE,
this will then automatically take you to the Membership page.

Legacies and Donations

Payments