Food and Solidarity Membership Form

Please fill in your name and address and other details

Name

First NameLast Name

£15 an hour

if you wage is £15 an hour

£15.00 for each month

£20 an hour

if you wage is £20 an hour

£20.00 for each month

Minimum wage membership (£10 a month)

£10.00 for each month

Unwaged Membership (£3 a month)

£3.00 for each month

Part-time/low-wage precarious work (£4 a month)

£4.00 for each month

£30 an hour

if your wage is £30 an hour

£30.00 for each month

£50 an hour

if your wage is £50 an hour

£50.00 for each month

£70 an hour

if you wage is £70 an hour

£70.00 for each month

Address

Street Address

Street Address Line 2

City

Post Code

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: 0000 0000000.

I want to receive regular parcels?