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First For Kirkby
Membership application
Putting Kirkby and Field Lane First
First For Kirkby agreed to become a membership
organisation at a public meeting on 11/10/2014.
Membership is open to all who live, work or trade in our
town and want to campaign for a brighter future.
All members are entitled to take part in the selection process
for candidates and participate in the making of our policies.
Membership is entirely free, and your details will only
be used for your membership of the party.
Name
Address
Post Code
Home Phone
Mobile Phone
E-mail
Ward
(DELETE AS
APPROPRIATE)
Cherryfield / Central / Whitefield
Northwood / Shevington / Park
Skills
Interests
If you would like to make a donation, First For Kirkby’s
bank details are:
Account number: 30069645
Sort Code: 60-12-25
This form should be returned to the Membership Secretary,
Matt Donnelly, who can be contacted on 07929 427 266 or
at [email protected]
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