 |
|
Please complete as many sections of this form
as you like, without any obligation. Return to:
NEW ALLIANCE,
PO Box 13199,
LONDON SW6 6ZU
We respect confidentiality and do not pass
on personal information to other organisations.
Data protection note: Safeguarding privacy,
GDPR and your right to object
1. REGISTRATION FORM
|
Name |
|
|
Address |
|
|
Daytime Tel |
|
|
Fax |
|
|
Evening Tel |
|
|
Mobile |
|
|
|
|
|
Which aspects of the EU do feel strongest about? |
|
|
Which anti-EU Groups do you actively support? |
|
|
Which community or other campaigning groups do you support? |
|
|
Do you hold any official positions? |
|
|
Are there any skills you can offer us? |
|
2. WOULD YOU BE ABLE TO ASSIST IN ANY OF THE FOLLOWING AREAS
Please Tick as appropriate
| Leaflet distribution | ___ |
| Writing letters to the press | ___ |
| Lobbying community or political groups | ___ |
| Light clerical work (at home) | ___ |
| Fund raising | ___ |
| Research projects | ___ |
| Organising activities (such as a public meeting or street stall) | ___ |
3. Financial Support
If you want an effective campaigning group, please make a contribution to New Alliance's running costs. Thank You. Make cheques payable to "NEW ALLIANCE" and send to the address above.
Name...............................................................................................................
Address............................................................................................................
Post Code.........................................................................................................
Sum donated.........................................................................................................
Date ....../....../......
OR
If you can help us with a Standing Order, to ensure we have a guaranteed income, please get in contact. (We do not publish bank details online).
Date this page was updated: 17 May 2018