Join Us - Registration Form

Customer Details:
Title

MissMrsMsMrMx
Full name*
Date of Birth*

MonthDayYear
Date
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Address*

Street Address

Address

CityCounty

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What best describes your ethnicity?*

White: English/Welsh/Scottish/Northern IrishWhite: IrishWhite: Gypsy or Irish TravellerWhite: OtherArabMixed: White and Black CaribbeanMixed: White and Black AfricanMixed: Other/multiple ethnic backgroundsAsian or Asian British: IndianAsian or Asian British: PakistaniAsian or Asian British: BangladeshiAsian or Asian British: ChineseAsian or Asian British: OtherBlack or Black British: AfricanBlack or Black British: CaribbeanPrefer not to sayOther
If you selected other, please feel free to self-describe your ethnicity:
Phone number*
E-mail*
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Employment Status*

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Job title*
Name of employer*
Address of employer*
How did you hear about us?*
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Employees United holds personal information about its members. This is used to provide members with the benefits and services to which they are entitled under Employees United rules, and provide information about other benefits and services which may be of interest. It may be used for statistical or other purposes relating to administration of the Union.*

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In order to provide you the content requested, we need to store and process your personal data. If you consent to us storing your personal data for this purpose, please tick the checkbox below.I agree to allow Employees United to store and process my personal data.**

I agree to allow Employees United to store and process my personal data
Membership Payment *
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MembershipThis payment will leave your bank account every month on the 15th of each month. If you cancel your payment you will no longer be a member of Employees United.
£9.50 for each month

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