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New Membership, Membership Renewal and Donations by cheque to the United Kingdom Independence Party

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.................................. Phone (day)...................
email.................................................. DOB....................
Parliamentary constituency............................................

Indicate here whether you would be interested in:
   [ ] becoming an active member of a local branch
   [ ] standing as a candidate
   [ ] assisting in campaigns/leafleting

Donation to UKIP :
Membership subscription:
One year's membership : £20 { }
Student/Pensioner :          £10 { }
Total enclosed; £...................................

Please make cheques payable to UKIP and post to:
UKIP Chichester c/o 21 Newlands Lane, Chichester,
PO19 3AT

UKIP rules state that a new member's joining fee can be kept for the use of the recipient branch. Thus, by ensuring new members send their membership application form and cheque to the Chichester Association, our Branch funds will be boosted. All membership renewals must be forwarded to Head Office. Therefore, if you pay by cheque or cash please return this form, together with your remittance, to the Association Membership Secretary, 95 St Leodegar's Way, Hunston, Chichester PO20 1PE.

However, if you choose to paya by credit/debit card then, please, send your application to join to our Head Office.