Your Contact Details

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About You

We require details about your age group and area in order to put you in contact with the most appropriate person. Please provide as much further information as possible.

Your Age (Required)
---13-1718-2525-3535-65Over 65

Your Area (Required)
---Belfast (East)Belfast (North)Belfast (South)Belfast (West)East AntrimEast LondonderryFermanagh & South TyroneFoyleLagan ValleyMid UlsterNewry & ArmaghNorth AntrimNorth DownSouth AntrimSouth DownStrangfordUpper BannWest TyroneOther

Postcode

Your Gender
---MaleFemaleOther

Are you a member of a Union?
---NoBECTUCWUEquityFBUGMBINTONASUWTNIPSANUJPCSProspectSIPTUTSSAUCUUTUUNISONUNITE the UnionUSDAWOther Union

Are you a Student?
---NoYes - UniversityYes - FE CollegeYes - School Student

Anything Else?

Why would you like to Join the Socialist Party? Any other comments?

Please tick at least one, I would like:
 To just receive more information at the moment To discuss with a member or come to a meeting to find out more To join Socialist Youth To join the Socialist Party

I confirm the details above are correct and am happy for a member of the Socialist Party to contact me