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Name
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Email
Telephone
Issues that interest you(e.g. air pollution, fracking, nature, roads, waste, etc)
How you can help (e.g attend meetings, distribute flyers, helping on stalls etc)
Subscription options
Family / Higher Wage Subscription ( £ 1.00 GBP for each month.)

Individual Subscription ( £ 6.00 GBP for each year.)

Discount Subscription (OAP / Student) ( £ 3.00 GBP for each year.)
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