Becoming a supporting affiliate
Payments are taken by direct debit.
Affiliation
Membership
*
Supporting Affiliate
-
£ 25.00
Please renew my membership automatically.
Membership will renew automatically.
Total Amount
Email Address
*
New Organisation
Organisation Name
*
Please enter here the primary email address we should use to correspond with your group. (This can be the same as the one entered above.)
Email (primary)
*
Please give us the name of a person who can be a point of contact between your group and Keep Our NHS Public. If your organisation does not have a group email address, we may also list the contact person's email address publicly on our website for the benefit of those wishing to contact your group.
Contact person
*
Contact person email address
*
Select the region or devolved nation within the UK that your organisation is based in. Leave blank if your organisation is a UK-wide organisation.
Region
- select Region -
Greater London
South East England
South West England
Midlands
East of England
Yorkshire
North East England
North West England
Scotland
Wales
Northern Ireland
Affiliate groups are entitled to have two delegates on Keep Our NHS Public's Steering Group (SG). If you would like to be represented, please give the name(s) and email address(es) of one or two delegates who can represent your group on the SG. An SG delegate may be the same person as the contact person mentioned previously. All SG members must be subscribed individual members of Keep Our NHS Public.
SG delegate 1
SG delegate 1 email address
SG delegate 2
SG delegate 2 email address
More information
Select the kind of organisation that your group is. If you aren't sure and the first three don't apply, put "Civil Society group".
Organisation type
*
Trade union (e.g. branch)
Trades council
Political party
Civil society group
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