Application form for members of affiliated organisations

Submitted by Tony Read on Mon, 05/10/2020 - 23:41

If you are a member of an organisation which is affiliated to Leeds Cycling Campaign, you are entitled to join the Campaign at a reduced rate.

The reduced rate for 2021-22 is just £5.00.

To join at this rate please complete and submit the web form below.

When filling in your details, please be assured we'll only ever use your information for the purposes of this campaign - no personal information is passed to a third party. View our Data Privacy Policy here.
Select your subscription rate and payment method using the drop-down menus
Click the Join button to submit your application, and then (crucially):
Visit our special payments page to make your payment.
We'll tally up the application with your payment and get your membership pack out to you ASAP.

Please send any questions to membership [at] leedscyclingcampaign.co.uk

First name *

Last name *

Address 1

Address 2 *

Address 3

Postcode *

Landline

Mobile number

Email *

Which organisation do you belong to? *

Please give your organisation's affiliation code *

Subscription rate *

Once you've clicked 'Join', please follow the link to the payments page. You can pay by bank transfer, or send us a cheque.

How will you be paying? *

Select how you intend to pay your subscription

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