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Membership Application /
Renewal Form
The party believes that our Parliament should be
directly and solely accountable to the electorate of the United Kingdom, not
subservient to the political institutions of the European Union. Continued
membership of the European Union is totally incompatible with this principle.
Furthermore, the party will campaign to restore accountability at all
appropriate levels of government in order to re-establish electorate's
confidence in our democracy at both local and national level.
Title..................
Forename(s)............................................................
Surname...........................................................................................
Address...........................................................................................
Town...............................................................................................
County............................................Postcode.................................
Telephone (Day) ................................ (A/h)
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Parliamentary constituency if
known..................................................
Please
indicate here whether you would be interested in:
becoming an active
member of a local branch;
standing as a candidate;
assisting in
campaigns/leafletting
Membership subscription (please make
cheques payable to UKIP)
One year's membership: £20.00 ,
(Donation optional) £....................
Total enclosed:
£...............................................................................
Send to: U.K.Independence Party. Rochester House.
145 New London
Road. Chelmsford. Essex. CM2 0QT
Freephone 0800 5876587
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