Update my membership Step 1 of 3 33% What details would you like to update?* My postal address My email address My phone number My Direct Debit membership fee My equalities information My name Request a new membership card Name* First Last This field is hidden when viewing the formTo confirm your details please enter one of the following: Co-op Party Membership number Email address Postcode To confirm your details please enter your email* This field is hidden when viewing the formPostcode6 Digit Co-op Party Membership number (if known) Update your nameYour Previous Name MsMrMrsMissMxCllrDrReverend Prefix First Last Your New Name MsMrMrsMissMxCllrDrReverend Prefix First Last Update your postal addressYour new address Street Address Address Line 2 City Postcode Update your email addressYour Old Email Address Your New Email Address Update your phone numberMobileHomeUpdate your membership feePlease choose your membership rate 1917 Club (£19.17 per month) 100 Club (£8.50 per month) Solidarity Rate (£5.80) per month) Standard Rate (£3.80) per month) Reduced Rate (£2.80) per month) Youth 14-19 Rate (£3 per year) How would you like to pay for your solidarity rate membership?£5.80 per month by Direct Debit£69.60 per year by Direct DebitHow would you like to pay for your standard membership?£3.80 per month by Direct Debit£45.60 per year by Direct DebitHow would you like to pay for your reduced rate membership?£2.80 per month by Direct Debit£33.60 per year by Direct DebitHow would you like to pay for your 1917 Club membership?£19.17 per month by Direct Debit£230 per year by Direct DebitHow would you like to pay for your 100 Club membership?£8.50 per month by Direct Debit£100 per year by Direct DebitName(s) of Account HolderAccount Number (8 Digits)Sort Code (6 Digits)Equalities InformationWhat information would you like to update? Disability Ethnicity Gender Sexual Orientation Why are we asking for this information? The information provided will be added to your Co-operative Party membership record, and used to facilitate your membership of our networks, including voting in internal elections. The information will also allow the Party to better understand the diversity of its membership. Providing this information is voluntary and you can decide to answer some questions and skip others. All data provided will be stored securely in keeping with our Privacy Notice, and will not be shared with our local branches or anyone outside the Party. You have the right to request the deletion of some or all of this data at any time.Do you consider yourself to have a disability? Yes No Prefer not to say Do you consider yourself black, asian or minority ethnic (BAME)? Yes No Prefer not to say Do you consider yourself to be LGBT+? Yes No Prefer not to say What is your gender? Female Male Other Finally, please confirm your date of birth to save your changesDate of birth* Day Month Year NameThis field is for validation purposes and should be left unchanged. Contents