Instruction to your Bank or Building Society to pay by Direct Debit

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Are you a member of a trade union? Yes No
Are you studying at college or university? Yes No
First name
Surname
Address
Yes, I would like to join the SNP and help make history.
Telephone
Mobile
Email
Date of birth
1
) My Details Complete step 1, then choose your payment method 2 or 3, before signing at step 4.
Gender M F
Do you have a disability? Yes No Are you a member of an ethnic minority community? Yes No
2
) Id like to pay by direct debit Paying by Direct Debit reduces our admin costs. Thank you.
3
) Id like to make a one-off payment Why not spread your payments by Direct Debit? Youd be saving us 5 in admin costs.
Please choose your payment amount. If you can afford
to give more than the minimum, please tick () a rate
according to your income.
Please return this form to: Scottish National Party, 3 Jacksons Entry, Edinburgh EH8 8PJ
Name(s) of Account Holder(s)
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Account number Branch sort code
Originators ID number
6 7 0 9 0 1
Signature(s)
Date
Mr Mrs Miss Ms Other
To join the SNP now, visit www.snp.org/join or complete this form.
4
) Declaration
MONTHLY 2 4 8 My choice or ANNUALLY 12 24 48 My choice
Please debit my account on 1st or 16th of the month.
Minimum Suggested My choice

Individual 12 48
60 and over 5 20
15 and under 2 8
Unwaged 5 20
Overseas 25 100
Life Membership 725
60 and over Life 450
Please debit my account number Maestro only
Valid From mm/yy Expiry Date mm/yy Maestro Issue No. Security No.
Signature Date
Postcode
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The last 3 digits on the
reverse of your card
I hereby apply for membership of the Scottish National Party and agree to be bound by the principles
of membership. The SNPs membership criteria appear on our website snp.org/eligibility
Signature Date
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The SNP respect your privacy and will only use your personal data to keep you informed of our campaigns and other opportunities to support the Party. If you prefer not to receive any future information, please contact us.
OR please debit my Debit/Credit Card
And I wish to make a donation to the SNPs
Independence Referendum campaign fund

To the manager
Address
Instruction to your bank or building society: Please pay the Scottish National Party direct
debits from the account detailed in this instruction subject to the safeguards assured by
the Direct Debit Guarantee. I understand that this instruction may remain with the SNP
and, if so, details will be passed electronically to my Bank/Building Society.
Postcode
Name and full postal address of your Bank/Building Society
Banks and Building Societies may not accept Direct
Debit instructions from some types of accounts.
Reference (SNP official use only)
I enclose a cheque/postal order payable to Scottish National Party
to the value of

Unsure of your eligibility? If you are unsure whether you are eligible or have any other questions about membership
please call 0131 525 8925. Lines open Mon-Fri 9am-5pm
Join Now!
www.snp.org/join