MEMBERSHIP FORM

Please print complete and return to: Membership Secretary: Jo Allen, 19 Ward Road, Norwich, NR13 6RG
Tel: 01603 720364 Email: joallenlesc@hotmail.com

. . . . . I am a member of the Labour Party. Please enrol me as a member of the Labour Euro-Safeguards Campaign.

. . . . . I am not a member of the Labour Party, but I wish to support the Campaign and to receive its literature by means of a library subscription.

I enclose a cheque PO payable to the Labour Euro-Safeguards Campaign for

. . . . £5 . . . . £10 . . . . £15 . . . . £20 . . . . £25 . . . . £Other

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Postcode . . . . . . . . . .

Telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Where applicable: Your CLP . . . . . . . . . . . . . . . . . . Your Union . . . . . . . . . . . . . . . . . . . . .