Membership and affiliation form

Marx Memorial Library

& Workers’ School

Membership & Affiliation Form Sign up as an individual member or affiliate your local, regional or national trade union, campaigning, political and progressive organisation to receive: • Access to our extensive archives and collections • Regular updates and newsletters about forthcoming events • Access to our lending library • Discounted rates for venue and room hire • Guided tours of Marx House • Participate in our lectures, seminars and education programmes

Join/Affiliate online at www.marx-memorial-library.org.uk

Marx Memorial Library & Workers’ School Membership & Affiliation Form FILL IN USING BLOCK CAPITALS IN BLUE/BLACK INK SURNAME FIRST NAME(S)

MR/MRS/MS/DR/PROF

ORGANIZATION NAME (IF AFFILIATION) POSTAL ADDRESS

TOWN/CITY

POSTCODE

LANDLINE

MOBILE

EMAIL DATE OF BIRTH

ANNUAL MEMBERSHIP RATE: r £20 INDIVIDUAL r £10 CONCESSIONS r £25 OVERSEAS

MALE/FEMALE/TRANSGENDER

ANNUAL AFFILIATION RATE: r £50 BRANCH/LOCAL ORGANISATION r £250 REGIONAL ORGANISATION r £500 NATIONAL ORGANISATION

I also would like to donate £................ Make cheques/PO payable to Marx Memorial Library & Worker’s School

r

I am a UK taxpayer and would like this and any future donations to be treated as Gift Aid donations. I understand I must have paid an amount of income and/or capital gains tax equal to the tax reclaim on my donation in the relevant tax year.

STANDING ORDER MANDATE My Bank........................................................................

My Bank’s Postal Address.......................................... ......................................................................................

Account Holder(s)........................................................ ........................................................................................

Sort Code

......................................................................................

Please pay by banker’s standing order, cancelling any previous instructions to the payee: Pay to: Co-operative Bank; Sort Code: 089033 Account Number: 5042539200 Account name: Marx Memorial Library & Workers’ School Amount (words): Amount (figures): Date of first Payment: Frequency: Annual/Monthly

Account No

oooooo oooooooo

Signature(s)................................................................... ........................................................................................

Name (Block Caps)....................................................... ........................................................................................

Date ...............................................................................