Green Liberal Democrats Membership Registration
Membership Registration Form for The Green Liberal Democrats
Email *
Name *
Liberal Democrats Membership Number
Required for full membership. If you have any other party allegiance it must be declared.
Mobile
NUS number or UB40 reference
Required only if claiming the concessionary rate when between the ages of 25 and 65
Optional Communications?
We will contact you about your membership and for General Meetings, usually by email. This is required. For other communications, please tick to indicate which methods we MAY use.
Data Permission *
By completing this form you affirm that the data given above is correct at the time of writing and give permission for it to be entered onto the GLD membership database and used as per their data use guidelines published online at: https://greenlibdems.org.uk/en/page/membership-faq 
Required
I have payed the Green Liberal Democrats (per annum)
Clear selection
If you are a Councillor or Key Activist please specify role
Do you have any particular interest or expertise on environmentalism that could benefit the GLD or other members? 
Would you like to volunteer for the Green Liberal Democrats committee? 
A copy of your responses will be emailed to the address you provided.
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