Food and Solidarity Membership Form

Please fill in your name and address and other details

Name

First NameLast Name

I want to receive regular parcels?

£15 an hour

if you wage is £15 an hour

£15 for each month

£20 an hour

if you wage is £20 an hour

£20 for each month

Minimum wage membership (£10 a month)

£10 for each month

Unwaged Membership (£3 a month)

£3 for each month

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

£4 for each month

£30 an hour

if your wage is £30 an hour

£30 for each month

£50 an hour

if your wage is £50 an hour

£50 for each month

£70 an hour

if you wage is £70 an hour

£70 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: 00000000000.