Embargoed! Membership Form

Please note we can only accept cheques made payable from UK bank accounts. If you do not have this and do not wish to join online, then please arrange for a bank transfer. Our bank details and the membership process to be followed our given below.

If you do have a UK bank account, then please complete the following Embargoed! membership joining form and together with your cheque made payable to Embargoed! please post to:
Embargoed! Suite 205, 14 Tottenham Court Road, London W1T 1JY.

Membership type - please specify which (fees are in Great Britain Pounds - GBP):

Individual Membership is £10 and is renewable on a yearly basis.		£10	[ _ ]

* All correspondence, including the bi-monthly Engage member newsletter, by email only
** Includes worldwide postage for bi-monthly Engage member newsletter

Please add your personal/business details:

Title	[ _ ] Mr   [ _ ] Mrs   [ _ ] Ms   [ _ ] Miss
First Name	______________________________________________
Surname	______________________________________________
Business Name	______________________________________________
Country of Residence	______________________________________________
Address ______________________________________________ ______________________________________________
Postcode	______________
Please give us your email address if you would like to receive updates and news by email. We won't share your email or other personal details with anyone else
E-mail address	______________________________________________
Telephone Number	______________________________________________
[ _ ] Your details will be held on our database so that we can keep you updated about our work. From time to time we may ask for your help with our fundraising and campaigning. If you do not wish us to contact you about this please tick here. [ _ ] For more information on how to become an active Embargoed! member please tick here. [ _ ] To receive your quarterly Engage newsletter by email only (which helps cut down on printing/postage costs for us and is also more environmentally friendly) please tick here. By joining Embargoed! you agree to: • join Embargoed! and support its campaign to end the embargoes against North Cyprus • pay the annual membership subscription to Embargoed!, which will be renewable from the date your application is processed • have your name added to the petition supporting the Charter of Fundamental Rights of the Turkish Cypriot People Total fee paid to Embargoed!: • My annual Embargoed! subscription fee is GBP __________ In addition to your annual membership fee, you can also make a donation to Embargoed! Please add in the total donation you wish to make here: • I would like to make a donation of GBP __________ to Embargoed! • Total payable to Embargoed! including donation GBP __________ Signed: ___________________   Date: ______________ Please print and send this completed form, together with a cheque (UK bank accounts only) for the appropriate amount to: Embargoed! Suite 205, 14 Tottenham Court Road, London W1T 1JY For direct payment from your bank to Embargoed! Embargoed! bank: NatWest Bank, Tottenham Court Road branch, London W1, UK Embargoed! bank account name: Embargoed! Embargoed! bank account number: 26635232 Embargoed! sort code: 56-00-31 Please post, fax or email the completed form together with the bank and account number you will be issuing payment and the date this was made (so we can reconcile your payment with your form). Thank you.