Join UsPersonal InformationTitleName *Email *Mobile *Landline *Trade Union (Optional)Membership NumberMember of an ethnic minority community?YesNoGenderManWomanTransNon-binaryOtherDo you have a disability?YesNoAddress *Town *Postcode *Date of Birth *MEMBERSHIP RATESStandard Rate£3/month (£36/year)Reduced Rate£1/month (£12/year)Other Rate£3/year Choose RateChoose RateStandard Rate (£3/month) (£36/year)Reduced (£1/month)(£12/year)Other (£3/year)Yes, I wish to pay this rateReduced£1/month (£12/year) (Please tick all that apply)I am a member of a trade union affiliated to the Newham Independents PartyName of trade union *I am retired, unwaged or working fewer than 16 hours per weekI am aged between 20-26Other£3/year (Please tick all that apply)I am a studentName of institution: *Graduation date: *I am aged between 14-19By completing and returning this form, you agree to accept and conform to the constitution, programme, principles and policy of the Newham Independents Party. By providing us with your personal details and information about your views, you are opting in to allowing the Newham Independents Party and its representatives to use these, as well as other information to which we are entitled, to contact you by email, text, phone, websites and apps even though you may be registered with the Telephone Preference Service. You may opt out of being contacted at any time. Your personal information may be used to help us provide you with information to match your interests and/or to alert you of campaigns or events in which you may be interested. In addition, when you join the Newham Independents Party, we will collect, hold and process personal information in order to service the contract that you enter into with the party. This information will also be used for the administration of the Newham Independents Party’s own internal governance and membership systems. For the Newham Independents Party’s full privacy policy and how we use your data please see: newhamindependents.org/. The printed rates are correct until 31/12/2024 Membership fees are subject to Newham Independents Party rules and may vary from those detailed on this form. Promoted by Zulfiqar Butt, on behalf of Newham Independents Party both at 24 Orwell Road, London E13 9DHSubmit