Please fill in membership application form

First Name:
Surname:
Address 1
Address 2
Address 3
Address 4
Your County
Post code
Telephone number
E-mail address:

I am a member of a Retail Co-operative Society or of another Co-operative organisation recognised by the NEC of the Party.

Name of Co-operative Society

Your share number if known and if approriate

Membership Details

You will receive a membership card, a membership pack and details of your
Co-op Party Branch. The membership fee is £10 for waged and £6 for unwaged
members. It is possible to arrange to pay by direct debit, but it is more
convenient to pay directly to the branch Treasurer.