CiviContribute

Sign up for membership

Membership *

Individual membership - £ 22.50

Student membership - £ 7.50

Total Amount

Email Address *

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Password

Confirm Password

Provide a password for the new account in both fields.

Membership signup (East)

First Name *

Last Name *

The Organisation field is a lookup with autocomplete. Start typing and try to find a match. If no match is found, please enter your Organisation manually.

Organisation

Telephone

Newsletters

Midlands Region newsletter

National newsletter

North East Region newsletter

North West Region newsletter

Scotland Region newsletter

Data sharing

Yes No

I am willing to share my contact details with other members.

New membership (East region)

Membership