Membership Form - Sarah Russell

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East Lothian Conservative & Unionist Association Become a Member / Renew your Membership As a member, you can play an active role in the Party, from attending Conservative Party Conference and taking part in local campaign groups to choosing the candidates who will stand in local and parliamentary elections and voting in leadership elections. We value committed members like you – join the Party today. Choose the membership that best suits you: Membership Tick box Standard £25 a year Members play an active role in the Party, can attend our annual Other amount £ Conference and receive voting rights in Party elections after 3 months of membership. All from £25 per year. Armed Forces £15 a year Standard Party Membership - and all associated benefits - is offered at a reduced rate for serving or former members of our Armed Forces. Under 26 £5 a year Standard Party membership - and all associated benefits - is offered at a special £5 rate to those aged under 26. Become a Donor or Add a Donation to your Membership We need to build a strong voice for local Conservatives and we can only do that with your help. Any donation will make a difference. £ £25 £50 £100 Other Please tick box or insert amount Membership Applicant Details This section should be completed by all applicants: Title Forename Surname DOB Address Postcode Town/City Phone Email East Lothian Conservative & Unionist Association Please complete the form using Block Capitals, print, sign and post to: Your Payment Details Organising Secretary, ELCUA, 4 Church St, Haddington. EH41 3EX This section should be completed if you would like to set up a Standing Order: Beneficiary Details: Bank of Scotland, Haddington Branch. Account Name: East Lothian Conservative & Unionist Association Account Number: 00336182 Sort Code: 80-08-23 Bank Account Details Bank Name & Postal Address Account Name Account Number Sort Code £ Amount of my regular payments Monthly Annually (Please tick one box) Start My Standing Order dd/mm/yyyy For How Long dd/mm/yyyy Start Date Until Further Notice (Please tick) Or End Date Print Name Date dd/mm/yyyy Signed This section should be completed if you would like to pay by cheque and posted to the address above. I enclose a cheque made payable to ELCUA. (Please tick) All party members are bound by the General Terms and Conditions found at www.conservatives.com/join Political Party Elections and Referendums Act 2000 Under the Political Parties, Elections and Referendums Act 2000 (PPERA) you must be on the electoral register in the UK excluding the Channel Islands and the Isle of Man in order to make a donation of more than £500. If you donate more than £1,500 to the Party, we are obliged under the PPERA to report such a donation to the Electoral Commission, who will publish the fact that you have made a donation over £1,500. For more information, please see electoralcommission.org.uk The Conservative Party uses the information you provide for the purposes of democratic engagement. This covers a wide range of activities inside and outside election periods, including but not limited to democratic representation; communicating with you; surveying and opinion gathering, campaigning activities; activities to increase voter turnout; supporting the work of elected representatives, prospective candidates and official candidates; and fundraising to support any of these activities. Please tick this box if you would like the Conservative Party to use the contact information you provide to contact you about the YES party’s campaigns and opportunities to get involved. Full terms of use and your rights are available in our Privacy Notice at www.conservatives.com/privacy In order to qualify as a member with full voting rights, the minimum subscription is £25. This does not apply if you are aged 25 or under. You must be 15 years or above to qualify for full voting rights. In order to qualify as a Youth member, please supply your date of birth and email address. Promoted by East Lothian Conservative & Unionist Association, both of 4 Church St, Haddington. EH41 3EX