Application Form for remaining Westminster Parliamentary Seats

Personal Information
First Name*
Last Name*
Full name to appear on ballot paper*
Membership Number*
Do you have at least 12 months continuous membership?*
- YES
- NO
Please be aware that it is a requirement for all applicants to have at least 12 months continuous membership.
Are you a member of a trade union?*
- YES
- NO
Please be aware that it is a requirement for all applicants to be a member of a trade union.
Which trade union are you a member of?*
Region or Nation*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Which CLP do you currently reside in?*
Have you participated or are currently participating in one of the following??*
Current Occupation*
Phone
Email
Address
Street Address Post Code City County Country
Please list all current and past social media channels
This should be a link or a handle to the social media account in question.
https://twitter.com/UKLabour
www.labour.org.uk

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Seat Preference
Please inform us of your three preferences for standing in the seats listed. You don’t need to complete all three preferences. If you would like to be considered for all of the remaining seats, please let us know by selecting “YES” below.
Would you like to be considered for all of the seats listed?*
Preference 1
Preference 2
Preference 3

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Let's get Britain's future back